Seanad debates

Thursday, 6 December 2018

Health (Regulation of Termination of Pregnancy) Bill 2018: Second Stage

 

Question proposed: "That the Bill be now read a Second Time."

10:30 am

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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I welcome the Minister of Health, Deputy Harris, to the House.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I thank the Acting Chairman. I am delighted to join Senators in Seanad Éireann for Second Stage of the Health (Regulation of Termination of Pregnancy) Bill 2018. The Dáil concluded its consideration of all Stages last night and voted in overwhelming numbers to care for women with compassion in our country rather than exporting women with crisis pregnancies to other jurisdictions, as we have been doing for more than three decades. I look forward to the opportunity of considering and debating this landmark legislation with Senators today and next week, with the hope that we can finally act on the instruction that people gave us more than six months ago to do our job as legislators and to legislate to legally provide these services in our country. We must do that in January 2019. I must apologise as I will have to leave the Second Stage debate early to attend a Council of Ministers meeting in Brussels but will be represented by my Ministers of State. I look forward to being here for the duration of Committee and Report Stages next week, when we will have the chance to tease through many of the issues.

As Senators will be aware, the introduction of this Bill aims to give effect to the result of the referendum on Article 40.3.3 held in May. It is fair to say the result of the referendum showed us that the people want Ireland to be a country which treats women, our sisters, friends, daughters, mothers, wives and colleagues, with consideration and empathy at a time when they most need that care. The main purpose of this Bill is to set out the law governing access to termination of pregnancy in this country. The legislation permits termination to be carried out in cases where there is a risk to the life, or of serious harm to the health of the pregnant woman; where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth; and without restriction up to 12 weeks of pregnancy.

I need to level with the Seanad as to how I will be approaching this debate. We took a very conscious decision - a decision that was welcomed by many - in advance of the referendum to publish draft legislation, so that when people were voting "Yes" or "No", they knew what they were voting for. They knew that if they gave me as a Minister and these Houses of the Oireachtas a mandate to legislate, we would endeavour to legislate along the lines of the draft legislation. Now that the referendum is passed different people have different views on the legislation and that is right and proper. The job of legislators is to scrutinise. The approach I will be taking to the Bill is to do what I promised the people I would do if they passed the referendum and repealed the eighth amendment.

I will take the Members through the Bill section by section to clarify its provisions. While the Bill is now arranged slightly differently, its key provisions are largely the same as those published in the draft general scheme approved by Government and published in March ahead of the referendum, and also the updated scheme approved by Government and published in July. The Bill is now divided into three Parts. The first Part of the Bill has sections on definitions, regulations, repeals, transitional provisions and a review of the operation of the Bill. Section 1 of the Bill makes the standard provisions setting out the Short Title of the Bill and arrangements for its commencement. Section 2 deals with definitions. It defines the meaning of some of the terms used for the purposes of the Bill, including foetus, medical practitioner, medical procedure, and termination of pregnancy. I clarified in the Dáil - this is an important clarification that I was very pleased to give - that while the definition of "woman" set out in the Bill “means a female person of any age”, it is to be understood in line with section 18(b) of the Interpretation Act 2005, which states that “a word importing the feminine gender shall be read as also importing the masculine gender”. I want there to be absolutely no doubt on the record of this House, as there is no doubt on the record of the other House, that termination of pregnancy services may be accessed by anyone who requires them regardless of gender. I had the opportunity of meeting LGBT Ireland, BeLonG To and Transgender Equality Network Ireland, TENI, to explain to them my approach to this. It was my simple layman's view of the world that we could just stick in "and pregnant person" or the likes. The clear legal advice I got from the Attorney General was that was not without risk. What I have done, as Members will see, is that I have made a change to the explanatory memorandum, which I have shared with those advocacy groups, with the health committee and with Members of the other House, to make it absolutely clear that this legislation is inclusive from a transgender perspective. That was certainly recognised and acknowledged in the other House and I want to acknowledge it here today also.

Section 3 deals with regulations, allowing the Minister of the day to make regulations to bring the legislation into operation and other such procedural matters. Any such regulations will have to be laid before the Houses of the Oireachtas for approval. Section 4 allows that approved expenses associated with the administration of the Bill may be paid for from public funds. Section 5 repeals sections 16 and 17(1) of the Censorship of Publications Act 1929; sections 7(b) and 9(1)(b) of the Censorship of Publications Act 1946; and section 10 of the Health (Family Planning) Act 1979. It also repeals the Regulation of Information (Services Outside the State for Termination of Pregnancy) Act 1995; and the Protection of Life During Pregnancy Act 2013. That was an Act introduced at a time when we had the eighth amendment and now that the eighth amendment no longer exists in our Constitution, we can through the passage of this Bill repeal that Act.

Section 6 sets out transitional provisions to put arrangements in place to cover situations where a review committee has been convened under the Act of 2013, and is ongoing at the time the present Bill comes into effect. It also obliges the HSE to prepare and submit a final report on reviews to the Minister, not later than six months after the commencement date of the present legislation. Section 7 makes provision for a review of the operation of the legislation not later than three years after its commencement. I inserted this clause in the Bill during its passage through the Dáil, and it is a very important one. What we do not want to do, or what I certainly do not want to do, is to pass a law, put it on the Statute Book and say that is our job done and we are finished talking about these issues. This is an area that requires ongoing monitoring and evaluation and as medical evidence and public policy change, we need to be able to ensure that the legislation we have enacted is operating effectively. Within three years, there will be a full external review of the Act from the perspective of how it is operating. I am sure there will be lots of issues that we will discuss on Committee Stage and while I will not be in a position to accept some of them, they are certainly issues that will be looked at in the context of a review. That is a perspective I will be taking through this debate as well.

Part 2 of the Bill covers the grounds on which terminations of pregnancy may be lawfully provided under the legislation and includes arrangements for conducting reviews, and provisions on certification and notification of procedures under the legislation. Section 8 defines the meanings of some of the terms used in this Part of the Bill, including health, appropriate medical practitioner, medical specialty, relevant specialty, obstetrician, review committee and viability. Sections 9 to 12, inclusive, set out the grounds on which termination of pregnancy may lawfully be provided. Section 9 states that a termination of pregnancy may be carried out where two medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that there is a risk to the life, or of serious harm to the health of the pregnant woman, that the foetus has not reached viability and that it is appropriate to carry out the termination of pregnancy in order to avert the risk concerned. One of the two medical practitioners must be an obstetrician and the other must be an appropriate medical practitioner, and both must certify their opinions in order for the termination to be carried out. The procedure must then be carried out by the certifying obstetrician, or in cases where the second certifying doctor is also an obstetrician, either one may carry out the procedure.

Section 10 deals with emergency situations. It provides that a termination of pregnancy may be carried out by a medical practitioner who, having examined the pregnant woman, is of the reasonable opinion formed in good faith, that there is an immediate risk to the life or of serious harm to the health of the pregnant woman, and it is immediately necessary to carry out the termination of pregnancy in order to avert that risk - in other words, it is an emergency situation. The certification for the procedure may be issued by the medical practitioner either before the procedure is carried out, or where this is not possible, not later than three days afterwards.

Section 11 puts provisions in place for carrying out a termination of pregnancy in which there is a condition present affecting the foetus that is likely to lead to the death of the foetus before or within 28 days of birth, or what we now commonly know as fatal foetal abnormalities. The process is consistent with the other sections, requiring the involvement of two medical practitioners, one of whom must be an obstetrician and the other a medical practitioner of a relevant specialty.

Section 12 provides that a termination of pregnancy may be carried out by a medical practitioner who, having examined the pregnant woman, is of the reasonable opinion, formed in good faith, that the pregnancy concerned has not exceeded 12 weeks of pregnancy. A three day period must elapse between certification and the procedure being carried out. I amended this section in the Dáil after engagement with the medical community to allow a second doctor to become involved following the three day period, should the first be unavailable. I believed that because of the three day period, there was very much a practical issue here that doctors had highlighted to me, which we have endeavoured to rectify as well.

Sections 13 to 18, inclusive, set out the arrangements for reviews of medical opinions, where this is sought by a pregnant woman or person acting on her behalf. This will be familiar to the Members from other legislation. Section 17 refers to the review committee.

Section 18 provides that the HSE must submit a report to the Minister for Health, not later than 30 June each year, on the operation of review committees. Information that will be provided in the report includes; the total number of applications received; the number of reviews carried out; in the case of reviews carried out, the reason the review was sought; and the outcomes of such reviews. Section 19 deals with certification, and states that it must be made in a prescribed form and manner, and must contain the prescribed information, which may include the clinical grounds for carrying out the procedure.

Section 20 provides for a notification system in relation to all terminations of pregnancy carried out under the terms of the Bill. This is required to monitor the impact, effect and operation of the Bill.

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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Is a copy of the speech available?

Photo of David NorrisDavid Norris (Independent)
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I was just going to ask.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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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.

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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I thank the Minister. Many speakers are indicating. Group spokespersons have 12 minutes each and everybody else has eight minutes and members may share time. Senator Ardagh is sharing with Senators Clifford-Lee and Ned O'Sullivan.

Photo of David NorrisDavid Norris (Independent)
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Senator Bacik and I are sharing time since everybody else is.

Photo of Maire DevineMaire Devine (Sinn Fein)
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I am not sharing.

Photo of David NorrisDavid Norris (Independent)
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The Senator is in Sinn Féin, so she would not share.

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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Senator Norris and Senator Devine through the Chair, please.

A Senator:

Sharing is caring.

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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I am sure he may say the same. We will have a nice respectful debate.

Photo of Catherine ArdaghCatherine Ardagh (Fianna Fail)
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I thank the Minister for coming to the House. Obviously a lot of his time and work has gone into getting the Bill to this point. I look forward to debating it compassionately and respectfully with my colleagues over the next week or so. Last night the Bill was passed in the Dáil by 90 to 15 votes following many hours of debate in the House which the Minister attended. I hope we can follow on in this House with a passionate and compassionate debate, respecting all the views of colleagues in the House.

I thank the members of the Oireachtas committee who spent hours in the dungeons of Leinster House bringing the matter to the stage where it could be put before the people. The people unequivocally decided that the legislation we are now debating was to become law. Ultimately it ensures that women facing a crisis pregnancy will get the compassion and support they need and will be treated properly in this jurisdiction for the first time. Having a child is a special thing and every child is cherished. The legislation will affect and support women in crisis pregnancy for the various reasons the Minister has outlined.

I thank the medical practitioners who are working behind the scenes on guidelines. They have informed me and other Members of this House along the journey to get here. Sometimes we forget to thank them for all the work they continue to do in the background.

I know many of the provisions of the Bill may need to be scrutinised further. There are provisions on criminality and practicalities relating to doctors certifying. I hope we can iron out some of those issues to make the Bill even better so that when it is implemented it serves them to the best we can as legislators.

I again thank the Minister and look forward to next week's debate.

Photo of Lorraine Clifford LeeLorraine Clifford Lee (Fianna Fail)
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I thank the Minister for coming here today. He has had a long number of days debating the legislation in the other House. It is a great relief to have legislation before us eventually. I pay tribute to the Minister and everybody who worked in a collective manner to bring us to this point today. I refer specifically to the committee that debated it for many months. It took a very acute personal toll on members of the committee. I pay tribute to the Chairman of the committee, Senator Noone, and other members of that committee who are in this House. It was fantastic work and represented a new approach to solving a big issue that had been long debated and considered so divisive that we, as legislators, could not even touch it. Setting up the Citizens' Assembly and then the Oireachtas committee is a very good model. I was sceptical about it at the start, but I now think it was a very good model to follow in future.

I also pay tribute to many groups in civil society who kept the issue burning for 35 years and never let it go. They worked very hard often putting their own safety at risk to ensure the issue would not be allowed to fade into the background. I pay tribute to the many women who had to bring their cases to court. I refer specifically to Amanda Mellet and many others who had to remain nameless. I also pay tribute to Savita Halappanavar who in her tragic and misfortunate death brought us to this day. It accelerated the pace of change and we should remember her today.

I pay tribute to the hundreds and thousands of Irish women who bore a very private pain and shame completely unnecessarily. They had to travel to get basic healthcare and went through unbelievable grief over the years. I am glad that we can finish the journey of rectifying that awful position into which we, as a State, put them.

I look forward to a respectful debate in the coming weeks. We should not have a rerun of the referendum at this point; we have had that debate.

Photo of Lorraine Clifford LeeLorraine Clifford Lee (Fianna Fail)
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Let us just debate the legislation.

Some of my colleagues feel differently from how I do, but I respect them and I hope they respect me. Let us try to fulfil the wish of the people at this point. There is no need to go over the same divisive arguments which would help nobody. We really need to move on with it. The people have spoken overwhelmingly and the people are sovereign. It is now our duty to fulfil their view that was clearly articulated to us. Let us have the debate on the specific amendments. Let us move on, get our business done and give the women of Ireland what they desperately need.

It is important to point out the severe lack of investment in female healthcare specifically. I want to see increased investment in women's healthcare across the board which has been sorely lacking over a number of years. The women of Ireland are finally finding their voice and it is being heard. The Minister has an audience there and we need him to push for more of the budget to be allocated to specific female health issues, sexual education and issues on other aspects of reproductive health. We need more lactation consultants, more community midwives and many more supports for women. We need more supports for women who have suffered loss in pregnancy and postpartum depression. We cannot just focus on one aspect of female healthcare and think we have that box ticked. I want this to be the start of a conversation and an evolution to respecting women far more.

I look forward to a respectful debate in the coming days.

Photo of Ned O'SullivanNed O'Sullivan (Fianna Fail)
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I could say much more, but I will just use the four minutes available to me. I thank our party Seanad Leader, Senator Ardagh, for generously sharing her time with us. There is an old Irish proverb, "is binn béal ina thost"; sometimes one can say too much. This topic has been debated ad infinitumover decades and in more recent time in the Oireachtas committee, of which I was glad to be a member, and it clearly had a long drawn-out debate in the Lower House in the past two weeks. My priority is to expedite business in the Seanad today and in the week ahead.

I commend the Minister on his sterling work on the topic over a long period and hopefully we are coming to a satisfactory outcome. Naturally and quite properly it will be teased out here in the Seanad because it is very important legislation. I respect everyone's right to scrutinise it and contribute on it. I do not like to see people who deliberately set out to thwart the undisputed and decided will of the people. Some of the debate in the lower House yesterday seemed to take place almost in a bubble as if we never had a referendum. There was a referendum in which the people spoke and gave a resounding decision on the issue. As parliamentarians, our function here is to give effect to the voice of the people. If there are amendments, we will discuss them hopefully in a positive and compassionate manner. It is not a matter for politicking.It is not a subject on which any individual's set of moral beliefs should gain ascendency over any other's. No matter what side of the spectrum one is on, we are all trying to do our best here as honest, decent individuals responding to what is a considerable issue in our society. I urge all Members present and those who are not to get involved in the debate, not drag it out, make their point and try to get the legislation over the line so it can be concluded as we go into 2019, hopefully to a bright new future for this country.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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I welcome the Minister to the House. I thank him from the heart for all his work on this issue. It has been a privilege to work with him so closely on it. I thank colleagues across the Houses and also members of the committee. There was such respect and collegiality, for the most part. This may not have been highlighted enough. Much of the time, one hears about the negativity. I hope this Chamber will be a place in which we discuss this legislation in a practical, meaningful and respectful way and that we will not experience the kind of negativity and filibustering we witnessed in the Lower Chamber, which in many ways was a lower Chamber at certain times in recent weeks.

I am pleased to be at this Stage. It has been a busy and intense year and a half for many of us and it has been an intense 35 years for many who have been involved in this issue. As Senator Clifford-Lee said, we seriously need to pay tribute to those who kept this issue on the agenda and did not let it fall down the political priority list. It is important to pay tribute to the Taoiseach for committing to a referendum on practically the day he was put into office. I also pay tribute to former Taoiseach, Deputy Enda Kenny. When he suggested the Citizens' Assembly, the idea was much maligned. It has proven to involve an effective process of deliberative democracy we should be proud of as a country. If our nearest neighbour had a deliberative democratic process on the issue that has taken up so much of its time and ours recently, there might well have been a different outcome in its referendum. That we had a citizens' assembly was useful. There was a suggestion it was somehow out of touch with the people but it was not. When people heard the facts and the reality for women, they voted as they did at the assembly.

The process that started at the Citizens' Assembly was continued in the hearings of the parliamentary committee on the eighth amendment and then it proceeded to the Government. That three-pronged process is an effective method and one that should be used again on a difficult issue. It has also been used on climate change. One cannot compare the two issues directly but climate change is an issue of great importance. The mechanism is one we should use as a Parliament and society to address issues that are difficult for the country to deal with.

This is one of the most important Bills, if not the most important, that will have passed through this Chamber in many years. The decision that now faces us will have a profound effect on how we treat women in Ireland. In a way, in recent years, we said "Enough" to the way women have been treated over the years. We said "No" to continuing to have an English solution to an Irish problem. I do not want to rehash the referendum debate but let us be clear that no woman ever wants to have an abortion. It is not an easy decision for anyone. For years, we just turned our backs on women in this country. As a society, we chose silence as opposed to companionship for women and other citizens. What we are now proposing will allow women to choose what is best for them and their families, in conjunction with their doctors. This goes to the core of the issue. We are asking that trust be placed in women in dealing with the heartbreaking reality they sometimes have to face, alone or with their families.

Over recent days and weeks, we have heard many statements and noted amendments seeking to collect data and record heartbeats, whereby the Bill could almost be used as a form of contraception. It is just nonsense. Let us be clear that the people have spoken. As much as 66.4% of the people said they want to change the law. Our duty is to carry out the people's will and have the courage to bring our country forward.

There has been some concern over regret that women feel and such matters. It speaks to the fact that most pregnancies are much wanted. No one wants to be faced with a decision to terminate a pregnancy. We need to have a legislative framework that allows individuals to make decisions they believe are right for them in the circumstances. It is a difficult reality of life that complications do arise. Life is complicated and we need a legislative and healthcare framework that facilitates people in difficult circumstances. We must provide the best possible care and support for women.

Following on from what the Minister spoke about and the ancillary recommendations, which by all accounts did not receive enough emphasis because we deal with the more obvious headline issues, I contend that we need to address contraception and sex education. We need to bring the country into the 21st century when it comes to sex education. That is the reality. It is normal in life for people to have sex. The reality is that we need adequate sex education. I do not know about any other Senator but I was shown a video by the nuns. We have moved on a bit from that but we are still not in the 21st century when it comes to sex education.

Photo of David NorrisDavid Norris (Independent)
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Hear, hear.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Even when it comes to sexually transmitted diseases, we still do not have a full understanding. Children need to be taught about these matters as early as is deemed appropriate. We need to be just a little more grown up. Ireland has said enough to the way women have been treated. There has been a maturation process over the recent period. I hope we will be able to talk about breastfeeding and all the normal functions of life in a mature way. We have had Catholic guilt for far too long in this country over how we conduct our lives and in respect of so many facets.

The question is where we go from here. I hope that over the coming days we will have this Bill ready for signature by the President, although it might have to go back to the Dáil, and that we will have the desired facility provided in this country. There are so many other points to consider, however. Senator Clifford-Lee also alluded to this. Women’s healthcare requires considerable attention. It has been much neglected. What has been occurring is simply not acceptable anymore. Having passed this legislation, we will move towards addressing women's healthcare. Breastfeeding, sex education, counselling for women who go through difficult circumstances and many other recommendations of the committee will have to be front and centre over the coming years. There is a lot of time to be made up owing to how we treated women as a society over decades.

I am very happy to be at this stage after a lot of work by many people who worked together to get the Bill to this Stage. We have more work to do over the coming days. As I stated, I hope the debate will be respectful and purposeful and that we will get on with the work and have the Bill passed into law as soon as possible.

Photo of Maire DevineMaire Devine (Sinn Fein)
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I welcome the Minister to the House. It is with great pride that, as Sinn Féin's Seanad spokesperson on health, I speak on this historic and landmark legislation and can chart its journey not just from a year or two ago but from way back in the 1960s, when the feminist movement began in this country.It was a very cold place for those people then and recently it has been a cold country for women.

We must also mark today by thanking those women and men who, more recently, have got us to this point, including Ailbhe Smyth, Orla O'Connor, Gráinne Griffin, Dr. Peter Boylan, my party leader, Deputy Lou McDonald, the Minister for Health, Deputy Harris, and Senator Noone who chaired the committee, which was at times tetchy.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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That is putting it mildly.

Photo of Maire DevineMaire Devine (Sinn Fein)
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That is putting it mildly. I try to be polite when I can. I thank the young women who wore their "Repeal" jumpers who went door to door with clipboards in the months leading up to May. We must also thank the crews of people from Together for Yes, Grandmothers for Yes, and Travellers for Yes, and the Termination for Medical Reasons crew, with whom I had the privilege to work with in my own area of Dublin South Central and throughout the State. We must thank the women who opened their hearts to us and told us their stories that had remained hidden, sometimes for decades, and who felt unable to speak. I particularly want to thank the grassroots feminist movement in Ireland that started us on this journey. As I said, it was a cold place in which they spent decades trying to rid us of the conservatism that was smothering us all. They were fighting to revolutionise women's rights and women's reproductive rights way beyond and way before the eighth amendment was inserted into the Constitution in 1983. We should thank these people again and again because without them we would not be here today.

As my colleagues, Deputies Louise O’Reilly and Jonathan O'Brien, did in the Dáil, I intend to raise points in the spirt of co-operation and I wish to be as constructive as possible regarding the legislation because it is incredibly important we get this right. It is so important because right across the world we have seen that once abortion laws are passed it is sometimes very difficult to revisit them and perhaps in our case it might take another 35 years. As has been heavily reported in the media, we need to pass this legislation quickly, with 1 January as the enactment date. We must, however, also make sure that it works and delivers for women. This has been my stance and that of my colleagues as we have seen the Bill progress.

The public discourse during the referendum campaign reflected people’s understanding of abortion as a healthcare issue that should be addressed through progressive patient centred legislation, not through criminal sanctions. As we saw in the Dáil, however, the attempts by progressive Deputies to amend the offences section to ensure that it did not have a chilling effect were completely rebuffed. These offences act as a chilling effect and they are not a medical necessity. The legislation does not explicitly protect doctors nor does it protect in instances where a person may seek help from their mam or dad, their siblings or their friends to procure abortion pills. We have seen the damage this can cause in the North of our country where a mother is on trial for helping her daughter obtain abortion pills. Criminalisation of abortion leads to unsafe and illegal abortion and poor health outcomes for women. There should be nothing in the Bill that causes the doctor to think about anything except the pregnant woman. The Bill should also be free from anything that perpetuates a chilling effect or abortion stigma. These areas need to be looked at as we progress the Bill through the Seanad.

Currently, the Bill allows for abortion in situations of risk to life or health to avert the risk identified. "Avert" is taken to mean "eliminate" in medicolegal settings, suggesting an extremely high barrier for access to abortion care in these situations, and an obligation on women to endure a range of severe health conditions in pregnancy. I put it to the Minister of State, Deputy Jim Daly, that on Report Stage in the Dáil amendments were refused which would have replaced "avert" with either "mitigate" or "reduce" in order to ensure a practical and practicable level of availability of abortion care after 12 weeks. This argument against accepting change to this aspect of the Bill ignores the fact that appropriateness is assessed against the standard of aversion - in other words, the substantive question remains whether the abortion would avert the risk. Witness after witness who attended the Joint Oireachtas Committee on the Eighth Amendment of the Constitution stated that one cannot grade risk. The committee heard at length the challenges of fixing risk in legislation and accepted that the assessment of risk is best considered in a clinical setting and not defined in legislation as “serious” or “severe”. This provision should, therefore, be amended to better support medical practitioners’ clinical judgment. That is their job. They are the clinicians.

Throughout the campaign, we heard that we needed to trust women and that we needed to allow doctors to do their job and not tie their hands when it came to ensuring safety for women. There is still a conflict between sections 11 and 13 of the Bill and I am not sure this has been explored in enough detail. This amendment concerns the need for the certifying doctor to be the doctor who carries out the termination. A same-doctor requirement is not workable in practice due to part-time working arrangements, rosters, annual leave, sick leave or just not being available on the day. Again, it behoves us to see common sense prevail so the legislation can be workable in a practical sense.

With regard to the three day waiting period, or what has been dubbed the "Coveney cooling-off period", this was not a recommendation of the Joint Committee on the Eighth Amendment of the Constitution. There should be no possibility of the waiting period acting as an arbitrary barrier to care. Mandatory waiting periods are not clinically indicated, they impose significant burdens on pregnant women, with reduced access to medical practitioners, and they can cause delays. If a decision is made to include reference to a three day waiting period in legislation, it must begin from a woman’s request for an appointment with her medical practitioner and her initial contact whether it be by phone, email or in person, if it is to be at all workable in practice. Barriers in this instance will be damaging to women and will further force them to travel abroad or to procure abortion pills on the Internet. The exact purpose of this legislation was to stop this. The referendum campaign touched on all these issues and more than 66% of people who voted were adamant that they wanted to stop the situation where women are forced to travel abroad or to buy pills, which are unregulated, on the Internet. This legislation will have served its purpose only if the number of women travelling abroad for terminations or ordering abortion pills over the Internet goes down.

This section of the Bill is completely paternalistic and is insulting to women. A woman's decision to have an abortion is not taken lightly. Such a decision is taken after lengthy considerations, often weeks of processing their thoughts, feelings and assessing their future. In the majority of cases, it completely preoccupies women for much more than the three day trial, which some politicians seem obsessed with. There is also a blind spot in the legislation in respect of women who are under the 12 week limit but waiting the three days would take them over the 12 weeks and result in their inability to access the medical services. I put it to the Minister of State that perhaps the three day waiting period is a sop to those who are sitting on the fence or who were indecisive about allowing women to access healthcare. I believe it is sensible to ensure a clause to provide for a situation where the three day period is overly burdensome, for example, for a woman escaping domestic violence or for a woman in direct provision, or if the three days will see the woman exceed the 12 weeks, or another situation, and that the three days rule could be overridden.

There is belief among politicians that some sort of imagined community of middle Ireland exists and that they need the legislation to be conservative. Let me be clear that this is not the case. The RTÉ exit poll for the referendum revealed that 62% of people - of the more than 66% of people who voted "Yes" - had decided that their vote in the referendum was based on a woman’s right to choose. Unless amended, this legislation fails those voters and it fails women.Since being elected to the Seanad, I have shared my experiences as a psychiatric nurse and of learning and navigating this sometimes weird world of politics. In 1983, I was a young republican when 66% of Ireland voted to insert the eighth amendment into our Constitution. I did not vote to do so. I instinctively knew that my friends, sisters and I had no voice. We were smothered by the raging and damaging conservatism of the State - then led by the church - which put my health and that of my sisters and friends at risk. We grew up traumatised by and terrified of pregnancy and without sex education or access to independent GPs. We had no access to contraception. It was the dark ages for women and girls, but it was only slightly more than three decades ago.

I stand here today in a changing Ireland of which I am very proud. However, I will not be part of the cohort that would allow us to fall at the final hurdle in the race to enact the legislation. We need good, solid, reliable legislation. We have waited far too long. I will deal with the Bill in a spirit of generosity and I hope that the Sinn Fein amendments will be accepted in the same manner.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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Well said.

Photo of Lynn RuaneLynn Ruane (Independent)
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I welcome the legislation. This is a truly historic Bill that seeks to vindicate the decision made in the referendum in May, when 66.4% of the electorate voted to repeal the eighth amendment of the Constitution and allow broader access to legal abortion services in the State. I wish to pay tribute to the Citizens' Assembly for its work on the constitutional and legislative change required to end the injustice and hypocrisy imposed on women by the eighth amendment. I thank my colleagues on the Joint Committee on the Eighth Amendment of the Constitution for their detailed scrutiny and debate of those recommendations and their role in delivering them to the wider Oireachtas. I also wish to thank the public - the Irish electorate - who fundamentally and resoundingly rejected our hypocritical and horrific status quoand embraced compassion, care and autonomy for Irish women here in our country. I thank the activists who started work on repeal the day after the eighth amendment was inserted in 1983, before I was even born, and I thank those more recently responsible for creating a vibrant and energetic grassroots movement based on feminist principles which will fundamentally transform Irish politics forever.

The referendum was a fundamental rejection of the status quo whereby women were sent across the Irish Sea to access what we refused to make legal here. It shattered the political consensus on what we thought were the collective views of Irish people on abortion. In the light of the overwhelming majority who voted for change, we now have a mandate to go above and beyond what we thought possible or politically feasible before a referendum result that I am happy to admit took me by surprise in its overwhelming mandate for access for women above all else.

I thank the Minister, Deputy Harris, for the role he played in securing a "Yes" vote in the referendum. If a Minister for Health with contrasting personal views on this issue had been in office, things could have been very different. I wish to recognise his role in that process and in bringing the Bill through the Dáil and to this Stage in the Seanad.

There are positive aspects to the Bill. It provides for far broader access to abortion in the State, with legal access being allowed on grounds such as risk to life or health and fatal foetal abnormality and on request in early pregnancy. It is extraordinary to see a Bill such as this receive cross-party support in the Oireachtas. That is something which, even a year ago, many of us thought we might never see.

I welcome that the Protection of Life During Pregnancy Act will soon be repealed. It is a terrible law which I am glad will soon be consigned to the history books. However, it is very regrettable that so many of the provisions of the Bill before us have been taken from or inspired by that Act, which was roundly, regularly and rightly criticised by a wide array of international bodies, human rights organisations and providers of medical care to women. It had to meet the requirements placed on it by the eighth amendment whereby a woman’s life could only ever be equal to that of her unborn child. It treated women with suspicion and condescension such that their views on their lives and health did not matter. Access for a woman to a termination was the last consideration in terms of how it worked in practice.

It is unfortunate to see the hallmarks of that Act and the eighth amendment itself throughout the sections of this Bill, which is intended to vindicate a referendum decision that resoundingly rejected the premise that a woman needed to be on the verge of death to qualify for a termination. It is evident in the failure to completely decriminalise abortion, with the retention of the 14-year prison sentence outlined in the Protection of Life During Pregnancy Act, and in the stark admission in section 23(7) that “Nothing in subsection (4)shall operate to prevent or restrict access to services lawfully carried out in a place outside the State.” That provision is an explicit admission that, even after the Bill is passed, women will still travel for abortions. We have missed an opportunity to rip up the Protection of Life During Pregnancy Act and write a new law framed positively around access and placing a woman’s voice at the centre of her care.

As the Minister will be aware, Ireland has among the most restrictive abortion laws in Europe and that will continue to be the case after the Bill is passed.However, I want to work with what we have before us. Although it may not be perfect, it is a real sign of progress. However, on the most problematic provision taken from the Protection of Life During Pregnancy Act, I do not see how it is justifiable that the broad criminalisation of abortion services has been retained in the Bill. Every legal and medical expert who presented to the joint committee stated that abortion needs to be delivered as a normal part of women's reproductive healthcare and that any form of criminalisation surrounding it would hamper the judgment of doctors and harm access for women. Of course, sanctions should apply for wrongdoing and gross misconduct, in line with current Medical Council practice, but the Bill creates an extra layer of over-criminalisation that will smother medical practitioners and negatively impact on women. If a friend helps a woman to buy an abortion pill, as was the case in the recent case in Northern Ireland, that person is criminalised. A doctor who preforms a termination outside the narrow provisions of the Bill for a couple who have a devastating diagnosis of a fatal foetal abnormality will be criminalised. A doctor who terminates a pregnancy on the first day after the 12th week of pregnancy for a woman in a situation of domestic violence, addiction, mental health difficulty or disability will be subject to a 14-year prison sentence. This will have a chilling effect that will cause doctors to err on the side of caution and serve to limit access for women who need it.

Changes to the Bill to recognise the realities of the pressure on our health service are needed. Expecting the same doctor to certify and perform the termination is unrealistic. The Minister has recognised that requirement to be unworkable in the section pertaining to early pregnancy. I urge him to do the same in respect of the sections dealing with risk to health and fatal foetal abnormality.

The Bill provides for a three-day waiting period for terminations in early pregnancy, a provision not recommended by the Citizens' Assembly or in the report of the joint committee but included in the draft Bill published by the Department before the referendum. This issue was thoroughly debated in the Dáil and the Minister stated that people expect this provision in the law and, therefore, it must stay. However, the waiting period is provided for in a section of the Bill the main purpose of which is to allow for access to terminations in cases of rape. The section draws on the recommendation of the joint committee regarding the difficulties of legislating for access on that ground. Should a woman who has experienced rape have to wait three days without justifiable cause? That is what the Bill provides and it is simply without justification. As well as being unjustifiable for a woman who has experienced rape, a three-day waiting period will disproportionately affect poor women, migrant women, women with disabilities and women on the margins, those reliant on medical cards or a GP or hospital three or four towns away. I accept the Minister is of the opinion that the waiting period must remain in the Bill but, surely, we can build in some form of flexibility for exceptional cases, for the 1% or 2% of women it will actively harm. I assure him that such cases will arise and that those women will be harmed by this provision.I know we are on a tight timetable to get this Bill passed before Christmas and we want to work with the Minister to achieve that. However, the Bill needs improvement and we will table changes and expect them to be included to better ensure access for all women, but especially disadvantaged and working class women, who will be most impacted by its more restrictive provisions. It is a shame that the Minister did not accept a single Opposition amendment in the Dáil. There is no Government monopoly on best practice healthcare for women and I hope the Minister will keep that in mind on Committee Stage next week.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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Senator O'Mahony is sharing time with Senator Colm Burke. Is that agreed? Agreed.

Photo of John O'MahonyJohn O'Mahony (Fine Gael)
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I will be very brief. I am speaking on the Bill in a personal capacity and I appreciate the fact that I can do that. I put on record my total opposition to unrestricted abortion up to 12 weeks. I support the right to protect the life and health of the mother but I also respect the life of the unborn. There must be compassion for both the mother and the unborn. Compassion is not something that can be compartmentalised.

I respect the views of the health professionals who do not in any way want to be associated with this process. I am aware of the voice of the 66% of people who voted in favour of the constitutional change and I respect it, but 33% of people voted against it and their views need to be reflected here as well.

Photo of Ivana BacikIvana Bacik (Independent)
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I welcome the Minister of State, Deputy Jim Daly, to the House. I stand here with an overwhelming sense of relief after decades of campaigning on this. During that time I never thought I would see this day. I thought my daughters were going to have to face the same struggles I and so many women of my generation faced. We were too young to have voted in 1983 but we grew up all our adult lives under the shadow-----

Photo of David NorrisDavid Norris (Independent)
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Senator Bacik fought heroically. We should recognise that.

Photo of Ivana BacikIvana Bacik (Independent)
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-----and the chill of the eighth amendment. Let us be clear: 160,000 of us have faced that over the decades. Twenty-nine years ago, my colleagues and I in the students union in Trinity College felt it particularly closely when we were threatened with prison for giving information on abortion to pregnant women. What stands out for me is the memory of all the women who rang us, desperate for information, for a phone number for a clinic in England which they could not access anywhere else in those pre-Internet days. They were in crisis pregnancy circumstances none of us could have understood. I was only 21. It was unthinkable for us that we could do nothing legally to help those women, so of course we continued to give the information and to face prison. Happily, we did not get sent to prison because we had a wonderful legal team who represented us and made arguments based on European law that kept us out of jail, but we were declared bankrupt and the case went on for many years.

Information was a very live issue and remains so, until or unless we pass this legislation. One of the happiest provisions in the legislation before us is section 5, which repeals the Regulation of Information (Services outside the State for Termination of Pregnancies) Act 1995 and repeals censorship provisions still on the Statute Book because of our outdated and outrageous attitude towards women's sexuality and reproductive rights for so long. I am overwhelming relieved and happy that we are here today debating this legislation. I join with colleagues in commending all of the many people who worked so hard to make this happen. The Minister, Deputy Harris, has had to leave but as Senator Ruane rightly said, he played a significant personal part in ensuring the referendum passed this year. Senator Noone's calm steering of the Oireachtas committee was very impressive and, again, that played an important part. As I said on many occasions, the report of the Oireachtas committee makes for very instructive reading. I know there are many in this House and elsewhere who are not persuaded but it does make constructive reading to see the evidence basis on which the members of the committee, including a number of Senators and my Labour Party colleague, Deputy Jan O'Sullivan, were persuaded of the need to repeal the eighth amendment. I know from my personal conversations and knowledge of them that they did come with open minds. I know Senator Noone will agree with that. Many of them were not persuaded of the need to repeal the eighth amendment or had other views and were persuaded by the evidence they heard, in particular on the three grounds outlined in the report.

The first is the reality that women were travelling and continue to travel at the rate of nine women every day, adding up to between 3,000 and 4,000 women every year, and the fact that women are taking abortion pills at home in Ireland under constant risk of criminalisation. The second point was the medical evidence the committee heard that doctors themselves were feeling the chill of the eighth amendment, were constrained in medical practice and could not deal compassionately and justly with, for example, couples facing the terrible diagnosis of fatal foetal abnormality. The medical evidence was crucial. What I thought was also very interesting was that the committee was persuaded also by the evidence before it that Ireland remains in breach of international human rights law, in failing to give women recourse to health-saving terminations of pregnancy where necessary to save lives. I refer to the international human rights provisions, in particular the cases of Amanda Mellet and Siobhan Whelan, who took their cases before the UN Human Rights Committee. Before them, there were the women in the A, B and C case in 2010. Those cases were also very persuasive for members of the committee in terms of recommending repeal of the eighth amendment and therefore also the passage of this sort of legislation, providing for legal abortion services in Ireland.

That is how we came to this process and to the point where we have this legislation. Along the way there were many tragic and hard cases. The most tragic cases have been those of Savita Halappanavar, the appalling death of that young woman in Galway in 2012, but also the appalling case of PP in 2014. Any of us who had any knowledge of that case were utterly devastated by it. She was a young woman who was brain dead and was artificially kept alive because there was still a foetal heartbeat. There were some terrible cases involving utter trauma and anguish to many women and their families. We heard the testimony of the many brave couples and families in the Termination for Medical Reasons group who spoke also about the lack of compassion with which they were treated in Irish hospitals by Irish doctors who were again constrained by the eighth amendment. We cannot forget the many thousands of women who faced the double crisis of having to make the arrangements to travel, often in conditions of secrecy and not being able to access the funds to make the travel arrangements and having to travel to England to access the reproductive healthcare they needed there. The eighth amendment has caused an immense shadow for so long for so many people and it is really welcome that we are now at a position where we can debate sensible legislation of the sort before us in order for women to access the reproductive healthcare we need here at home in Ireland.

The Bill before us is closely based on the heads of the Bill published in advance of the referendum. The Minister, Deputy Harris, said that before he left the House. My Labour Party colleagues and I supported the decision to publish the heads of the Bill in advance. That was sensible and it informed the debate. It helped to give a shape to the campaign and it meant that we all knew what we were voting for. We do have to be cognisant of that when we are debating changes to the legislation, that this was very much the framework that was put before the people. It is quite in line with some other European countries and it is much more progressive than the 1967 Abortion Act under which 160,000 Irish women have had abortions, which effectively is Irish abortion although as Senator Noone said, it was the English solution to the Irish problem. That Act requires reasons to be given and proven by the woman. It requires two doctors to certify, even in early pregnancy. One of the most positive aspects of this legislation that was in the framework before the people in May is that it allows for first trimester abortion without the need to establish any grounds. I know the reason the committee recommended that was precisely because of women who were pregnant as a result of rape and who would otherwise have had to go through some awful legal process to prove rape. In my view the provision for abortion access up to 12 weeks without recourse to reasons is entirely sensible. It is more progressive than the English law. That is not to say there are not difficulties with the law. Other speakers have outlined some of them. For many of us who are pro-choice, as I am, the three-day waiting period is unduly restrictive and there is clear medical evidence of that.We will table amendments try to make that at least less burdensome. I am conscious that that was outlined to people in advance of the referendum, but I believe it should not be there. We should consider how we can adjust it to try to make it less burdensome for women.

Sections 9 to 11, inclusive, deal with abortions where there is a risk to life or health, in the case of emergency and in the case of fatal foetal abnormality. We need to ensure that procedures are not too cumbersome for the women, are workable for the doctors involved and do not amount to undue obstacles to women's access.

The section 23 provision on decriminalisation is crucial. We will certainly table amendments on that because we need to avoid the sorts of prosecutions we have seen in Northern Ireland where a mother was prosecuted for assisting her daughter to gain access to an abortion pill. It would be most unjust to continue with that kind of criminalisation in this law. I hope we can find a way to avoid that sort of impact of criminalisation. I take the point about the need to criminalise those engaged in, for example, coercive forced abortions. Clearly that must be outlawed, but there are other ways to do it and we need to look at those.

I welcome the Minister's commitment to introduce exclusion zones or safe-access zones in other legislation. I also welcome that the legislation will be reviewed. I hope that even if some of the changes we wish to see made are not made at this point, they are taken into account and made at a future date.

As others have said, we need to look more broadly at women's access to reproductive healthcare. We need to ensure that women, girls and boys have access to sex education and contraception. That was a key part of the ancillary recommendations of the Oireachtas committee's report. We need to be clear that we will get the Bill through in time to ensure that women will be able to access the services they so badly need in early January.

I wish to say a little more about the process which brought us to this Bill and the referendum campaign. Of course, I am glad to see the 2013 Act repealed. It was necessarily restrictive because of the eighth amendment. Those of us who sat in this House during the debates on that Act will remember how awfully hard it was to get that legislation through. Disgusting language was used against those of us who were simply promoting the right of women to have their lives saved through access to medical procedures and the right of doctors to be able to perform these life-saving terminations. Dr. Peter Boylan absolutely deserves commendation for standing out on that.

That legislative process was very important because without it the eighth amendment would not have been repealed. Some 77 women have had their lives saved over the period that Act has been in place. Flawed as it is, it has saved lives. It meant that for the first time we in the Oireachtas had to take on our responsibility as legislators to debate abortion in this House. That Act was very important at the time. I accept it is restrictive and I am delighted that it will be repealed, but we should not forget the context and the enormous opposition to it from many people who said it would open the floodgates and lead to women having access to abortion on demand. Dreadful language was used which was most anti-women.

There were other steps along the way, including the Citizens' Assembly under the chairmanship of Ms Justice Mary Laffoy and the Together for Yes campaign under the wonderful leadership of Ailbhe Smyth, Gráinne Griffin and Áine O'Connor. All of these people deserve enormous commendation.

I also commend my colleagues in the Labour Party. The Labour Party flew the flag in its opposition to the eighth amendment back in 1983 and pushed for repeal over many years when it was neither politically popular nor indeed safe to do so. Some of my Labour Party colleagues had protestors camping out in front of their homes and in their gardens. They were subjected to appalling verbal and physical abuse as I have also been over many years. Let us not forget that it took a long road to get here. It is extremely positive that we have reached this point. It is a great relief, particularly for the 66.4% who voted for the introduction of this legislation and for the many women who, I really hope, from 1 January will be able to access the services we so badly need.

Photo of Alice-Mary HigginsAlice-Mary Higgins (Independent)
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It is an historic moment. This is an issue that has spanned many decades of Irish life. Like others, I applaud those who took a very difficult stance in 1983 in highlighting the concerns, dangers and consequences for women that would come about with the introduction of the eighth amendment. Even if our recent referendum was difficult, the 1983 referendum was extremely difficult for those who campaigned against it and it had consequences for them. Of course many of the concerns they raised at that time came to pass. We have had many cases since then.

I first became aware of the issue in the early 1990s during the X case because it affected a teenager, as I was at the time, and that was when I first protested for repeal. As a teenager protesting at that time I did not believe it would take this long. I assumed people would realise the terrible consequences and things would change. Of course, it has taken decades since then. As has been described by others, we have had hundreds of thousands of women living their lives under a shadow, having their rights compromised, having their voice silenced, and having their experiences hidden. It is wonderful that we are able to move forward and open the topic up, and that Ireland is a country in which we can talk about these issues, respect each other, respect women and can trust each other to come with good faith to the legislative process, trusting women to make the choices that are right for them. It was clear from the exit polls on the night of the referendum that people trust women in the choices and decisions they make.

I pay tribute to the Citizens' Assembly for engaging in discussion with open minds. Their deep consideration and analysis was a model in respect for conversation and what that could be for Irish society. I give credit to those, including colleagues in the Labour Party, who first put the issue on the agenda for the Citizens' Assembly.

I particularly give credit to the Oireachtas committee and my colleague, Senator Ruane, who was the voice of the Civil Engagement group on that committee and, of course, the committee Chairman, Senator Noone. We were told the committee would entirely consist of heat and argument but, in fact, due to the contribution of those who steered it through, it actually shed light on issues that needed to be seen. Some of its very important recommendations were carried through in the Bill, particularly the recognition that the 12-week period was the only practicable way to deal with so many situations, including that of rape. That is a very positive aspect of the Bill which has many other positive aspects.

I also highlight some concerns. When people voted to repeal they did so because they heard about people's real stories - the real issues that affected women and their real experiences. They also heard of doctors' real experiences. I worry that parts of the Bill contain hard lines and hard absolutes that will not address the messy reality of people's experiences. A word such as "avert" is too hard a bar to reach. For example, does it cover cases where, for example, a 60% risk is reduced to a 20% risk? These are the kinds of questions that came up in the testimonies. I recognise that the three-day period will be there. As we continue to trust women, we will realise that this period is not necessary. I worry about the hardness of the interpretation regarding those three days in circumstances where there are situations that push people right over the line. I also worry about how the 12-week period might be interpreted because we do not want situations whereby intrusive medical practices will happen simply because doctors are worried about one or two days. Clarity is not necessarily always provided by hard absolutes with sanctions attached; clarity is achieved through guidance and good faith.

This brings me to my key concern regarding the Bill. There are a number of other issues we should address. There are other concerns about which the Minister has given us assurances about matters such as LGBTQI issues. In respect of the transgender issue, he has provided some assurance but there are people who are intersex or gender-fluid or who will not necessarily still be covered by what is laid down in the explanatory memorandum. That is a matter of concern. There are issues concerning conscientious objection. The Minister provided assurances in the Dáil last evening. When he returns to the Seanad, I will ask him to assure us that we will not see institutional conscientious objection coming into play in any way, be it by means of the letter or the practice. For example, we know that, in practice, there are many hospitals in Italy where people cannot access their rights. I agree that there is an obligation on every institution to deliver the service.

My key concern, which we will debate at length, is the question of criminalisation. People voted not to police women and their health. They voted to support them. There is no place in this Bill for criminalisation. If we need to address these issues, there is medical sanction. We have the Offences Against the Person Act. Placing criminal offences like this in the Bill dilutes the spirit and intent behind it. I am particularly concerned about section 23(4). We have been told this relates to force. This does not relate to coercion. We have debate coercion at length in this House and will have the opportunity again. Not only does this section leave well-intentioned people at risk of prosecution and not only is its terminology and the grammatical placing of it poorly phrased, there is a real concern that it does not do what it claims to do, which is deal with coercion. Rather, someone who is innocently counselling and helping the pregnant person and who has that individual's health and well-being in mind may face prosecution whereas an abuser may not. There is a real problem with that section that needs to be addressed. I know we will have an opportunity to address this.

This is a chance for us to try to get it right, learn globally and make sure we do not bring in any inadvertent or unnecessary obstructions. Let us pay attention to what has happened elsewhere in Europe and try to approach this in good faith. Everybody wants to make this workable and real. I look forward to that and I hope we will have no cases involving the letters "X", "Y" or "P" in the future. I am not confident we have guarded against that.

Photo of Colm BurkeColm Burke (Fine Gael)
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I welcome the Minister of State and I thank the Minister for bringing forward the legislation. The referendum was quite clear, as was the result - 66.4% in favour to 33.6% against. It is not like Brexit where by there was a marginal win for people who wanted to exit the EU. This is a clear mandate for the Minister, the Government and the Oireachtas to bring forward legislation. The Minister introduced the legislation before us, which was passed by the Dáil. He has clearly set out how this matter will be governed in this country and what will be the regulations in law. Sections 9 to 12, inclusive, set out the main provisions of the Bill regarding the areas that are to be covered. It is important that the Minister has dealt with all of the concerns that have been raised in recent years by means of the ground rules set out in these sections.

The Minister and the Government built up a level of trust with the electorate because if the electorate did not have trust in the Government in the context of bringing forward the legislation - and the draft proposals were debated during the referendum - there would have been no overall majority. That trust was built up. The Minister has now brought forward legislation that is exactly what was discussed before and during the referendum debate, which is extremely important.

People state that we are introducing abortion in this country. The reality is that termination of pregnancy has been available since the State was founded. In other words, we were passing the buck to another country. If we look at the figures for 2016, we can see that over 3,265 women gave Irish addresses when they went to the UK for terminations. In 2017, the figure was 3,001. If we look at the online figures, one company has reported that it forwarded abortion pills to 1,217 people in Ireland. That is one company. A second one indicated that it had supplied these pills to 878 women. One of the problems about online ordering is that it does not involve medical supervision because the system here does not provide for that in real terms. It is important that we will have proper legislation and proper regulation of all of this so that people can have access to the best possible healthcare. I refer, of course, to those women who find that they cannot continue with a pregnancy. The qualifying criteria under which terminations can take place are clearly set out in sections 9 to 12, inclusive. The Minister has worked very hard with the various medical organisations, the HSE and the hospitals to ensure that there will be immediate access to these services once the legislation has been enacted.

The Oireachtas now has a duty of care to the electorate because, in the aftermath of the referendum being passed, we are obliged to ensure that this services will provided to those who require it. If this service is not in place on 1 January, people may have a right to take legal action. That is the last thing we want. Previously, people were obliged to take court proceedings in order to access proper healthcare. It is important that this legislation is passed. There were over 180 Committee Stage amendments in the Dáil and the Minister dealt with each one very carefully. He has brought forward the best possible result in the legislation before the House. On that basis, it is important that we support the Bill.

I thank all of the members of the committee, such as Senator Noone and all other Senators involved, which dealt with the proposals put forward. The committee devoted a significant amount of time to carefully setting out how we might move forward with the legislation required in this area, engaging in a detailed examination and taking very detailed submissions from different groups. I thank the members of the committee for their contributions. It is important that we get this legislation through before the end of term in order that we can put in place the required mechanisms and ensure that the healthcare services required for these women will be available.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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I welcome the Minister of State and, in particular, I welcome this Bill. It has been a long journey. Senator Devine put it very well in terms of the need to salute everyone and not just the people who have been involved in recent months. I salute Senator Noone and all of my colleagues on the committee. We had a much easier task than that faced by the people who stood up to be counted at times when it was extremely unpopular to do so.In that regard, I want to recognise my colleagues, Senators Bacik-----

Photo of David NorrisDavid Norris (Independent)
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Hear, hear.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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-----Devine and Norris, and others. I do not want to leave anyone out. I do not want to offend anyone.

I remember the 1983 referendum because it was my first foray into politics. I am proud that my party, Sinn Féin, as a republican party, took the right stand then. We opposed that referendum. It was such a dark and awful time to be campaigning. As a teenager in the midlands, it was particularly tough. Christy Moore put it well in his song, "The Other Side", where he described the country at the time:

While men in black declare a social order

Frightened women sail to the other side

That is what will continue until this legislation is passed.

It is worth bearing in mind that, as we speak today, there will be nine women travelling to Britain for a termination. Across the State, there will be another three or four taking abortion pills on their own in a bedroom. There is something truly repugnant about the status quo, which is that one can have a termination, only do not have it here. Do not let us know about it, go elsewhere, deal with it somewhere else and then come back, but do not tell us about it. It is hard to believe that it has taken 35 years to change the position.

My experience on the Together for Yes campaign was inspiring because it energised so many people, in particular, young people, who came in to make a difference in that campaign. It was also inspiring because we saw all of us on the progressive left, colleagues from Sinn Féin, the Labour Party, the Social Democrats, the Green Party and the independent left, working constructively together in my town of Limerick, with no one trying to steal the limelight, to get the best result. I stated at one of the public meetings that if we could bottle that, if all of us on the left learned those lessons and focused much more on working together, what a different country we could have. Hopefully, we can get there, comrades, in that respect.

Today is a really great day. It is fair to commend the Ministers, in particular, Deputy Harris, on the way he has dealt with this, not only now but over the previous year. He showed leadership when it was needed and we need to recognise that as well. It is real progress.

In terms of this debate, we are off to a good start in the Seanad. It has been a respectful debate so far and I believe it will continue to be so. I truly hope it does not reach the depths of some of the debate in the Dáil. I truly hope we do not have to put up with filibustering. By all means, let us debate and respect each other's comments but filibustering at this stage of this long national conversation is uncalled for. I hope we do not find ourselves back in a "Doctor Who" tardis whisked back to 1955. Can the Senators believe some of the amendments in the Dáil this week calling on doctors to make records as to whether the person applying for a termination was married or not?

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Unbelievable.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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Shameful stuff.

With the greatest respect, because there are colleagues who take a different view on this, I would ask for this debate to be constructive on all sides. Surely we have earned that much. The Seanad can lead the way in this respect.

It is real progress, and yet, and I mean this respectfully, a missed opportunity in some respect. I will cite one example in particular. The vast majority of members of the Oireachtas Joint Committee on the Eighth Amendment of the Constitution, of which I was a member, were agreed that decriminalisation was necessary and yet it is not happening. I am an optimist and I would be optimistic. In particular, I am looking at my colleagues here who were on the committee. We should be able to work together on this and improve this Bill and we should have enough votes to do so. After all of this time, now is not the time to be quiet on the issue of decriminalisation.

Photo of David NorrisDavid Norris (Independent)
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Hear, hear.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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It is just not good enough. While I welcome that the review has been brought forward, from five years to three, we have already waited 35 years. Why should we wait another three years when most of us in this Chamber know that the issue of decriminalisation can and should be dealt with now?

I feel similarly about the three-day provision. I understand the politics around it. We are dealing with two deeply conservative parties effectively in government at present. There should also be leeway to try and create some more flexibility in relation to those three days. I would appeal to colleagues across the Chamber to work constructively with us to get that done.

Let us do the very best we can for the women of Ireland who have waited for far too long for recognition and justice. In years to come, we will look on that time between 1983 and this year as one of the darkest periods of our history. It is hard to believe that Government after Government sat on their hands and did nothing about it. However, today is a day to recognise the progress that we have made through co-operation and partnership across the political spectrum. Let us hope it continues. Let us all work together. Let us pass this Bill but let us make it better before we make it pass.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Being in the Chair and listening to Senator Gavan speak, I feel a sense of déjà vu. I will not get into that.

Photo of Niall Ó DonnghaileNiall Ó Donnghaile (Sinn Fein)
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Senator Gavan is a good speaker.

Photo of David NorrisDavid Norris (Independent)
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I will start by paying tribute to my colleague, Senator Bacik. It was remarkable that nearly 30 years ago, as head of the students union movement in Trinity, the Senator bravely and courageously stood out at a time when this was one of the most unpopular issues in Irish society. Today, it is important that we mark her contribution together with that of all the others who have been mentioned. I really want to put on the record my admiration and respect for Senator Bacik.

Photo of David NorrisDavid Norris (Independent)
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I put the issue of abortion on an election manifesto in 1977, which was before many of the Senators were born. I was trustee for the child in the X case. That was an eye-opener. That lovely family were strongly pro-life, and then it landed. That is what happens. When these human situations hit the family, there we are.

This legislation is rushed.

Photo of Lynn RuaneLynn Ruane (Independent)
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It is what?

Photo of David NorrisDavid Norris (Independent)
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An issue as important as this needs really careful consideration.

I would like to look at one issue to start off with, that is, the question of using GPs. That is a mistake. We should have clinics. What is wrong with having clinics here? If one had clinics in this country performing the abortions, one would avoid all the problems of conscience with doctors and others.

This is a really serious problem. I am strongly in favour of the woman's right to choose but I respect people's conscience and it is important that we do so. It is correct that there are exceptions in order that doctors who have a conscientious objection are not coerced into performing abortion but, from a principled point of view, if one has a deep aversion and objection to abortion, it is also a violation and is not appropriate to require people to refer because that comes close to aiding and abetting a criminal offence. It is aiding and abetting. If somebody deeply feels it is wrong, he or should not be forced into this situation. One would avoid this if one used clinics rather than GPs. It is not at all clear whether pharmacists, in providing the abortion pill, are covered by conscientious objection. If a pharmacist decides he or she does not want to and does not agree with it, he or she should be covered. It may surprise some people that I, coming from the position I do, have this respect for people's conscience but I think it is an important issue of principle.

I went to my doctor recently. A decent young man, he voted yes for abortion and all the rest of it. He was strongly in favour of it but he did say, to my surprise, that he had come across a considerable number of young women who had an adverse reaction, emotionally or psychologically, after abortion. I thought originally that this was scare tactics from the other side but, coming from the source concerned, it is obvious that it is not. I regret the fact that there is no provision for counselling after abortion for women so that they may apply for it. I understand from my colleague, Senator Bacik, that will be in another Bill.

Photo of Ivana BacikIvana Bacik (Independent)
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It could be.

Photo of David NorrisDavid Norris (Independent)
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It could be. I want to strike a note now and say I think it should be. It is important in a human sense that those women who have an abortion and then have an emotional reaction should be provided with counselling. The three-day waiting period is daft. It has an impact on the other positions taken by the legislation because we provide for abortions in certain circumstances, for example, in the case of a pregnancy of under 12 weeks’ duration, that can be accessed quite easily. However, the 12 weeks is reduced to nine if there is a delay of three weeks. That is another situation in which we need to be careful.

Trinity College initially refused to make me a tutor because I was a fairy. It eventually made me a tutor and gave me a chamber of 70 students who were all female. Trinity would not trust me near a man. Among these 70 young women a crisis pregnancy would arise approximately once a year. They would come to me in floods of tears, and I would listen and try to take the situation down a bit. I would ask if the man was still involved and engaged with her, if he was still supportive, if her family knew and so on. I would take the temperature down, and then tell her that the best thing I could do was to refer her to a non-directive counselling agency. There was such an agency in Mountjoy Square and I sent the women there. One girl from ten had an abortion; the others did not.

I am perfectly certain that if non-directive counselling had not been available, a majority of those girls would have had an abortion. They would have gone over to London in misery, fear and anxiety, gone into a telephone box, found a telephone number and phoned an abortion clinic. They would have had the abortions then come back to Ireland on the mail boat without any counselling, unable to tell people or to share the story when they came back. It is good that those days are gone.

I will end as I started by paying tribute to my colleague, Senator Bacik. Without her efforts we would not be here today. I congratulate the people as well. In referendum after referendum in recent years they have shown wisdom, maturity, decency and compassion. Like several others in this House, I was surprised by the margin of the vote. It is very clear what the people want, and it is up to us to deliver it for them.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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Like Senator Norris, I thank the people on this momentous occasion. They are most sensitive and sensible when they have to be. They have decided to provide choice, protection and freedom to women. They have been outstanding. I also want to thank the Citizen's Assembly, the Minister and the team in the Department who handled the brief, which concerned life and the end of life, brilliantly. I thank colleagues across the Houses, in particular Senator Bacik, and the brilliant, almost saint-like, Christ-like Savita Halappanavar.

I also thank other countries, especially England, which I believe saved women. Women were tortured. I lived through all of this. Indeed I have a young son, born in the 1980s, so I know the pain, trouble and torture of this. Without places like England and other places further afield, many women might have ended up in the river. In those places they received some solace and some peace. It was tortuous, and the journey must have been awful, but they were still able to find somewhere to go, someone to listen to them and someone to give them back their lives. They were allowed to make a decision for themselves there.

I am bit disappointed with the Bill. The Minister spoke about women's health, which is something we need to discuss. There are regularly negative reports in the paper about maternity services in Ireland, especially concerning the new maternity hospital and Holles Street. The problem lies not just with this Bill. I am sorry that there is no general section on women's health. We also constantly forget that sex education has an awful lot to do with young men. We keep talking about women and sex education and women's bodies. It is not possible to be impregnated without young men unless one is travelling at warp speed. Sex education should generally begin with young men, and that aspect has been left out.

Sections of the Bill are highly problematic. Section 23, which concerns criminality and a potential penalty of 14 years, is highly problematic. I do not understand how the Lower House let this through or what happened in the argument on that section. I will have to read the Official Report. I do not like it. We will tease it out ourselves. I also believe that section 10, which concerns the risk of serious harm to the health of the woman involved, is problematic. Is this to be the only ground most women will be able to attempt to use if they miss the 12 week deadline? What is that about? I do not like it; it is very narrow and might criminalise doctors and push them to use it as rarely as possible. It needs to be teased out.

Generally speaking, however, I am delighted with it. It is a real privilege to be here. Like Senator Bacik, I was here in 2012 and had to listen to oral pornography-----

Photo of Ivana BacikIvana Bacik (Independent)
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The Senator is correct.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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-----as I called it at the time, from people on the other side of the House when the majesty and privilege of a woman's body and the autonomy she had once she was over 18 were discussed. It is a momentous day in the Seanad. There are privileged days in here, and this is one of them. It is great that this can be argued across the House, with respect for all opinions. Pro-life and pro-choice positions both have a place.

Photo of Colette KelleherColette Kelleher (Independent)
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I acknowledge the bone fides of the Government in wanting to introduce safe abortion in Ireland. Having waited for 35 years we have come a very long way in a very short space of time. The Government wants to bring about positive change for women's health without delay, as Senator Marie-Louise O'Donnell mentioned. This legislation falls within that context, but we have to get it right. The Government wants to pass this legislation quickly, but it is essential that we do not rush. Taking time to reflect on it would help.

Like me and the 1.4 million people who voted for change on 25 May, we are impatient for the will of the people to be made real. I have waited 35 years to see this change for my daughter and my nieces. I was 21 in 1983. My daughter is 28 now. We have waited for all of those years to get this legislation right so that women can get access to the care they need. We need to get it right for women who need abortion care now and in the long run. In the Seanad we have the chance to reflect again on this, not to delay it, and to ensure that we are listening to women as well as taking into account the important perspectives of doctors and lawyers. I welcome the fact that a review is proposed after three years, but we should also be open to having a rolling evaluation, and perhaps annual reporting, so that we can iron things out as they arise. This is new territory for us. We have exported the problem of women needing abortion care, so this is new ground for us. Things will arise and we need to be able to sort them out in a timely fashion.

Tara Flynn is a brave activist and campaigner, as the Minister knows. Her testimony and honesty, at some personal cost to herself, was powerfully revealed in the course of the referendum campaign and in her one woman show, Not a Funny Word. She won many over during the campaign to repeal the eighth amendment and with the Together for Yes movement. She wrote to Senators, saying, “I am one of the many thousands of women who had to leave Ireland at a time of great distress, to access abortion care in the Netherlands.”

Photo of Colette KelleherColette Kelleher (Independent)
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She went on to write:

I had an abortion. It was the only option for me at that moment in my life, after much deliberation and consideration. I am not a criminal and nor are those who helped me. The voting down of amendments to decriminalise is perhaps the most chilling of all the outcomes from the Dáil debates, and debating the length of the proposed sentence is to miss the point. Criminalisation serves only one set of beliefs. It will cause barriers to access and will have an inevitable, terrible outcome.

She asks the Minister and this House to not let this happen and she speaks from the heart about the stigma and distress of criminalisation hanging over us in law. She urges us to make criminalisation something to be left in Ireland's past. As we introduce amendments on criminalisation, I know the Minister will bear the words of "Tara" in mind, speaking as she does for the thousands of women who have direct and lived experience of the stigma and distress of criminalisation of abortion choices.

I also want to raise some matters concerning the legislation outlined by the Southern Taskgroup on Abortion and Reproductive Topics, START, a group of doctors in Cork. I campaigned and canvassed side by side with them on the streets of Cork during the referendum. A statement issued by the START doctors in October deserves attention. It states:

It is not workable in practice if the legislation mandates that the doctor who certifies must be available three days later to facilitate the abortion by prescribing medication in primary care or arranging the termination in hospital. It will happen that the same doctor is not available for various reasons including part-time working or leave, as well as commitments to other duties or services. Where termination is carried out in hospitals, it will prevent arrangements for delivery being made in referring or local hospitals, where a person has been referred to specialist foetal or maternal medicine tertiary services.

The START doctors when on to state:

There is no medical reason for this requirement and it poses a serious risk to the implementation of abortion services in clinical practice. There are numerous examples of well-established protocols in primary and secondary care which allow the hand-over of care from one doctor to another so as to ensure continuity of care for patients.

Work was done on this aspect of the legislation in the Dáil but it would be useful if the Minister could clarify the position, particularly on abortions that take place in hospital between nine and 12 weeks. It has been fixed for GPs but I do not know that it is altogether clear in respect of hospitals. START doctors also recommend a two-way pathway of care between our tertiary and regional hospitals. In addition, they prefer the use of the phrase "consult" in section 10. We may not debate deleting "examination", although I would like to see it gone, but we might include "consult" as well as "examine". I hope the Minister might be open to that.

The START doctors are also concerned about the prospect of criminalisation for practitioners being retained. In their view, that will lead to an interpretation in law that is conservative. Lawyers have also raised important issues on over-criminalisation, "consultation" versus "examination", "avert" and "mitigate", certification and termination of pregnancy by the same practitioner and, of course, the waiting period of three days. I am also curious to know what is the definition of "serious" in section 9(1)(a) and the rationale for it in section 10(1)(a). Surely harm is harm, something that is not good for the woman. It sounds to me like a vague, non-medical term.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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Well said.

Photo of Colette KelleherColette Kelleher (Independent)
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Is a woman to risk life-changing injuries or disability as doctors debate when "harm to health" becomes "serious harm to health", with one eye on the 14-year prison sentence hanging over their heads? I conclude by asking the Minister, his officials and the Members to give due and respectful consideration to the matters raised and being put forward as practical amendments by myself and Senators Ruane, Higgins, Black, Bacik-----

Photo of Colette KelleherColette Kelleher (Independent)
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-----and others. I was about to come to that. I would also like to acknowledge Senator Bacik's role in all of this. We first met many moons ago in London-----

Photo of Colette KelleherColette Kelleher (Independent)
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-----when we were doing telephone lines, with people reversing calls from call boxes in rural Ireland, and trying to be a human face to women taking a lonely journey. This was well before the days of mobile phones. She and the committee has been brave and I commend the work of Senators Ruane, Gavan, Ned O'Sullivan, and Noone. I also mention Ailbhe Smyth. We would not be where we are without her. Our aim is true and that is to improve and get right long-awaited abortion care in Ireland, as voted for by 1.4 million people on that historic day in May. Today is another historic day. We need to get this legislation passed urgently but we need to get it done right as well.

Photo of Rónán MullenRónán Mullen (Independent)
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In the Minister's 15-minute speech in the Dáil when introducing the Bill on 4 October, it was telling that the words "baby", "child", "unborn" and "mother" were not used even once - not once. That tells us how much concern this legislation has for children in the womb, or for any concept of motherhood or family. I firmly believe the referendum decision and the introduction of this legislation are decisions which will be rued by future generations but that is a debate for another day.

I want to turn, briefly, to what is at the heart of this Bill, and it is truly frightening. The Bill defines "termination of pregnancy", as "a medical procedure which is intended to end the life of a foetus". That is worth repeating: "Intended to end the life of a foetus". It is telling that on an issue so laden with euphemism, no other form of words could be found to diminish or minimise the sheer gravity of this statement. This legislation does exactly what it says on the tin - it ends the lives of unborn children. It is a situation beyond tears. This has ceased to be something the Minister and the Government feel they have to gloss over. It is now worn on their sleeves; it is something they are proud of. Even extreme pro-choice campaigners, however, are embarrassed by just how stark that statement is.

On Committee and Report Stages in the Dáil, they tabled amendments thiat tried to tone down the language, removing the reference to the "ending of life", and replacing it with the usual language of "healthcare", and so forth. Those amendments were rejected and, therefore, the brutal reality of this Bill - the ending the life - is plain for all to see, written in black and white. This Bill is the first piece of legislation to be brought before the Oireachtas with the specific aim of authorising the ending of life since the Public Safety Acts of the 1920s and 1930s, which authorised the imposition of the death penalty. Now, more than 90 years later, the ending of life is again before the House, only this time it is packaged as "healthcare". It is a strange world where healthcare involves legislating for the deliberate ending of innocent human life. Will the Minister please address this and answer that question directly? What other "healthcare" involves ending a life? Can he point to other healthcare legislation on the Statute Book that refers to "ending the life" of something or someone? I would be interested to hear a specific answer on that point.

The Minister is not even here. This debate in the Seanad is seen as a tidying-up event, another example of what Hannah Arendt referred to when she talked about the "banality of evil". The fact that ending the life of any human being should be seen as some great advance in human rights or healthcare is grotesque in the extreme. Under this legislation, abortions are to be carried out entirely at the expense of the taxpayer. The Long Title of the Bill says that it aims "to make available without charge certain services to women for the purpose of termination of pregnancy". The grotesque figure of €12 million was put aside in the recent budget for the introduction of these services.

Abortion is an elective procedure, that is to say, in virtually all cases, that it is a procedure which is optional and not medically indicated or urgently needed to save a life. Perhaps the Minister can also answer this question: what other elective procedures are performed entirely at the expense of the State and taxpayers in all cases? I cannot think of any. Representatives of the ICGP, and the IGO were asked this same question at the recent Oireachtas Joint Committee on Health hearings on 19 September. They could not identify another elective procedure funded entirely by the taxpayer. Can the Minister please address this point? Why is abortion - and only abortion - to be the only elective procedure funded entirely by the State? How can this be justified, when other elective procedures will still be paid for by the person receiving the treatment, that is if they can endure lengthy waiting lists? Following decades of talking about universal healthcare, free at the point of treatment, it has finally been achieved, but only for the provision of abortion. What a shameful day for the health service.

The issue of freedom of conscience was brought into sharp focus by the emergency general meeting, EGM, of the ICGP last weekend which was convened to discuss this Bill. Always a man for a good soundbite, the Minister dismissed the doctors' concerns and was quoted last weekend as stating:

The law on abortion is changing. The law on conscientious objection is not changing.

Any rational analysis of this Bill, however, shows that this is simply not the case. As the law stands, if a woman presents at her GP to request an abortion, the GP can inform her that he or she will not take part in such a procedure, and at that point his or her legal obligations end. Under the Bill, however, if the same GP refuses to carry out the termination, a new legal obligation is placed on him or her to refer the mother and her baby to another GP in order for that doctor to terminate the life of the baby. By definition, therefore, the law on conscientious objection is being changed, despite the ministerial Orwellian doublespeak. Whereas today, a doctor can freely, and in accordance with his or her conscience, refuse to facilitate a termination of pregnancy in any way, shape or form, because he or she does not believe that it is not medicine or is not good for the mother and the baby in their best clinical and ethical judgement, from the day this new law comes into force, he or she r will be forced to facilitate a termination as a third party. It is doublespeak of the most nonsensical and objectionable kind for the Minister to suggest that such a fundamental change in the law is not a change in the law at all.As well as looking at what is in the Bill, we also need to address what is not in it. The Government could have included provisions to address a number of serious concerns expressed by voters, including a large number of those who voted "Yes". For example, there is no provision in the Bill to protect children who may be targeted in the womb as a result of being diagnosed with Down's syndrome and other genetic conditions where that occurs within the 12-week period, when no reason has to be given. This Bill brings about the appalling vista whereby a pregnancy which is entirely wanted by its parents ends up being “unwanted” and aborted, solely as a result of screening tests which show the baby may have Down's syndrome, or on the basis of the gender of the child. How can that be right?

The Minister, Deputy Harris, speaks about compassion and humane treatment. Where is the compassion and the humanity in making it perfectly legal for babies who are unwanted solely because of a genetic disability to have their lives ended? The Minister wrote in the Irish Independentthe day before the referendum: “We’ve specifically excluded disability for grounds for abortion in the legislation". I heard his former party colleague, Deputy Fitzpatrick, mention last week that Fine Gael head office produced a graphic for Twitter during the campaign, which stated: “termination on grounds of disability is prohibited”. The Minister says this is “specifically excluded” and Fine Gael says it is “prohibited”. Can the Minister please tell me where in the Bill is it “specifically excluded” or “prohibited”? The lawyers in the House will tell us that for legislation to specifically exclude or prohibit something, there must be explicit language in it which excludes or prohibits it. No such language exists in the Bill. Can the Minister please point it out to me, if I am wrong? What was it I said about Orwell? Can he also explain why, if both he and his party favour such an exclusion or prohibition, they opposed amendments to that effect in the Dáil? I look forward to addressing these issues and many others at later Stages of our consideration of the legislation.

Recent opinion poll research gives us a clue as to why the Government is in such a hurry to pass this legislation. A poll conducted by Amárach Research recently shows very strong opposition to core aspects of the legislation. Amárach found that just 30% of the electorate support abortion being funded by taxpayers, compared to 44% against. They found that 68% support the right of full conscientious objection for doctors not to participate in abortions, compared to just 17% against. With opinion polls showing such a huge level of public opposition to the main proposals in the Bill, is it any wonder the Minister wants to dismiss these amendments and ram the whole thing through as quickly as possible before a general election, whenever that takes place? With such huge opposition to the more extreme and heartless aspects of this Bill, I do not blame the Minister, Deputy Harris, for not engaging with voters on the amendments, or, rather, I understand why the Minister does not want to engage with voters on them - it would be wrong of me to say I do not blame him.

On Report Stage in the Dáil, the details of this opinion poll were referred to during a debate on an amendment relating to the use of ultrasound, for which the poll found strong public support. The Minister responded with what I thought was a very revealing comment. He said:

We hear a lot about opinion polls, Amárach being one, but we had a really big one where people went out and voted in the referendum in May. ... People made their decision in respect of this.

In the referendum, people were asked a binary question in the referendum: did they want to repeal the eighth amendment and give the Oireachtas power to legislate - "Yes" or "No"? The use of ultrasound, the freedom of conscience of doctors or the abortion of disabled children, and so on - none of these issues was on the ballot paper last May. Yet, the Minister is now using the referendum result, which merely gave the responsibility to the Oireachtas to decide how to regulate abortion in this State, conservatively or permissively, as it saw fit, to justify rejecting even thinking about any of these humanising amendments. He is ignoring amendments on the basis of this flimsy justification and, in fact, shutting down discussion on these issues. Essentially, he interprets the referendum result as giving him carte blancheto legislate in any manner he sees fit. How can this be right, particularly when 34% voted "No", and when so many "Yes" voters had serious concerns?

This is just the latest in a long line of recent examples of referenda being used and abused to justify populist grandstanding by our political class, and this Government in particular, but to do so at the expense of innocent unborn children and in a way that sets its face against any idea that abortion, even were it to be legal, is something to be regretted, or something on which we should try to build public policy so people choose differently. None of that seems to be permitted anymore, as a class of right-on politicians try the ultimate Orwellian stunt of trying to turn abortion into some kind of social good, which it can never be for the children who lose their lives or, indeed, for many of the women who suffer, despite the denials, despite the refusal to engage in discussion about abortion regret, despite the cynicism shown in the Dáil to real-life examples where women spoke about their abortion regret and despite the ridiculing of actual cases where it had occurred that people had survived abortions and gone on to live.

Despite all the negativity and the ridicule, there is a truth here. The truth is that innocent human life is lost. Adult life is wounded. This is a bad, bad day. It is certainly what I would regard as one of the saddest days in these Houses in recent years. People have given themselves, and the politicians here want to create some notion of, a right to choose that completely disregards an innocent, invisible but no less human creature. I hope and believe there will be a better day when we will find a way to heal the breaches that have been created here in this destructive law, which sets men and women against each other, which sets mothers and children against each other and which sets its face against finding a better and more humane way to deal with crisis pregnancy and protect all the human beings involved.

Photo of Brian Ó DomhnaillBrian Ó Domhnaill (Fianna Fail)
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I am happy to speak today on this important legislation. I recognise, at the outset, that regardless of our political or personal thoughts on this sensitive subject matter, we all have a legislative imperative to scrutinise the Bill and to ensure it reflects best practice. In particular, I was struck by comments made last night by my colleague in the other House, Deputy Lahart, that this legislation will outlive us all in terms of political endurance. For good or for ill, how we stand on this may go down as a defining element of our political and legislative legacy. This, once again, speaks to the need to carefully weigh the issues at stake and to give honest if uncomfortable appraisal of each of its sections.

In light of this, I was very disappointed to hear some weeks ago that the Minister sought a waiver from the Business Committee of the other House to forgo pre-legislative scrutiny. It is my sense that if that careful and exacting process had been engaged in, we might have avoided some of the more inflamed interactions that took place on Committee and Report Stages in the other House. Let us not repeat that mistake and seek to rush through legislation for the sake of adhering to some arbitrarily defined and ultimately self-imposed political deadline.

This House and its Members must be accorded the space and the respect necessary for sufficient analysis. The pace at which this process is moving in terms of parliamentary analysis is quite striking, as no one can reasonably deny. For instance, amendments to the Bill on Committee Stage, which is due to be held on Monday, have to be submitted within one hour of Second Stage concluding. That is unacceptable. It is also highlights the reality of what the doctors outside of these Houses are saying. This week, the renowned and respected Dr. Austin O'Kennedy in Donegal said the Government is trying to push through a GP-led abortion service without providing any training, resources or equipment to the GPs. He called the process an "outrageous farce". Yet, the Minister is expecting GPs to implement it.

The referendum result did not somehow magically confer a blank cheque on the Government in terms of simply being able to present a Bill while at the same time decrying any attempt to amend it. We have a noble and honourable parliamentary process in this Oireachtas. It cannot be hurried along like an unwelcome guest whenever the desire to do so suits our agenda.

I will now deal with the substantive issues. It is clear the most striking line in the entire Bill we have before us is to be found in the definitions section.It states ""termination of pregnancy", in relation to a pregnant woman, means a medical procedure which is intended to end the life of a foetus". That is an absolutely stark and unequivocal statement and one from which we must not shy away in the course of this debate. I am aware that some of those who supported the repeal of the eighth amendment expressed significant reservation about the use of this definition in the mistaken belief it somehow imported the ethical vision of the eighth amendment back into primary legislation. That, I believe, does not bear any reasonable scrutiny. We must call things by their proper names. We must not engage in euphemisms or indirect language that evades the true grave nature of the Bill and, more importantly, what it seeks to make permissible or lawful. We are dealing with circumstances in which the life of a human child can be ended. We need to face this squarely. If we cannot defend that rationale or we seek to minimise what it is we are really about, deep denial will continue on the issue.

There is much more that could be said. There are many questions I would like to put and, no doubt, we will have an opportunity to do so. There are many outside these Houses with reservations, including those whom the Department, the Minister and the Government would wish to implement the legislation from the new year. As Senator Norris rightly outlined, issues arise over conscientious objection. I agree with him. We have learned nothing from what is happening in Norway, for instance, where on 11 October a doctor whose employment had been terminated took a case to the Supreme Court and won on the grounds of conscientious objection. Despite this, we are denying the right to doctors, midwives, nurses and pharmacists here. There is much yet to be debated and teased out in this Bill. In rushing it through we are doing a disservice to the people. I appeal to the Leader of the House and the Minister, Deputy Harris, who is not here to allow us the space necessary to tease out some of the issues on behalf of people outside the Houses who are raising issues with us. It is our obligation to raise and highlight their concerns, particularly in the light of the fact outlined by Senator Mullen, that over 1 million people, including those who voted "No", are not in favour of this legislation, as proposed by the Government. This is particularly the case when the Amárach research analysis is taken into consideration. We have an obligation to deal with this issue. If it is only a few of us who are standing up to represent the people in question, so be it, but I will not be found wanting in that regard in the coming weeks.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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The Minister was here at the beginning of the debate when Senators Ó Domhnaill and Mullen were not. He is on Council business in Brussels. It is all well and good coming in at the end of the debate to say what the Senator said, but the Minister was here at the beginning of the debate and will be here all of next week. It is important that the record be correct in that regard.

Photo of Kevin HumphreysKevin Humphreys (Labour)
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I thank the Acting Chairman for clarifying the matter. I was here when the Minister made a very thoughtful opening speech on the Bill. He explained that he had to go to Brussels on Council business. It was prearranged, which I accept.

I followed the progress of the Bill in the Lower House very closely. I disagree with Senator Ó Domhnaill in that we will have adequate time to deal with the Bill in the House. We are all committed to examining very closely the legislation proposed. The Labour Party group will be putting forward some thoughtful amendments for the The Minister to consider. It is welcome that he has already taken into consideration the issue we raised at an earlier stage of safe access zones and that he will bring forward legislation in early 2019 to deal with it. I fully support him in that regard because I saw the disgraceful signs outside national maternity hospitals. God forbid that my wife or a daughter of mine would have to pass them to receive treatment in a maternity hospital. I just would not like it.

I, too, acknowledge the people who played a role in ensuring the discussion of the repeal of the eighth amendment was kept very much to the fore, including my colleague Senator Bacik. I also recognise the many very ordinary people who kept the discussion going. Their names will never appear in the newspapers and headlines or on radio shows. They worked quietly. Many of them were members of the Labour Party who, in the 35 years since 1983, worked slowly and diligently to make sure the issue was kept alive and that we would eventually overturn the provision. Criminalising women was one of the biggest mistakes made in the 100-year history of the State. I very much regret that happened.

I do not intend to speak for long because I find this subject quite emotional. I voted against the eight amendment in 1983. I campaigned against it and never believed that in my political life I would be speaking to this Bill. I will talk about this on Committee Stage. Very much as a man, I want to say a few things. I am sorry for the last 35 years of pain to women and their families. I say sorry to the 160,000 women who were forced to travel for healthcare. I say sorry to all of the families who were made to keep this secret and could not talk about it. Truly, as a man, I am sorry. I am sorry for all of the lives lost owing to the lack of proper healthcare. We all know the big names, but there were so many who had to travel to England and probably lost their lives. Women could not come back and talk about their experiences openly. We have met them. It was a terrible indictment of the State, for which I am truly sorry. We can and must do better. When the Bill is passed - I hope it will be passed in the allocated time - I hope we will put women’s healthcare to the fore and make up for what I believe were the horrendous mistakes of the past. I am sorry.

Photo of Niall Ó DonnghaileNiall Ó Donnghaile (Sinn Fein)
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Gabhaim buíochas leis an Aire as a bheith linn don phlé. I was not due to contribute to this debate, but, having followed the referendum campaign, I find myself in a privileged position in which, as someone from the North, I am afforded the opportunity to do so. Many of us were so desperate to take part and did take part actively in the referendum campaign, in travelling to counties Louth, Donegal, Dublin and farther afield. As noted by previous speakers, the campaign was of historical significance in an effort to right a wrong in society and afford healthcare and choice to women and families who might need be in need of care. I was moved not just in the last referendum campaign but in a number of others in this state. I felt a deep pang of misfortune that I would not have the ability to take part actively in a vote, but I fully understood and appreciated the significance of what was taking place. We looked on during the last number of referendums and will continue to look on in awe and with a degree of frustration and, I dare say, jealousy owing to the progress being made in righting an injustice when we pass this legislation in this House.

One of the main things that moved me was the very natural, organic grassroots response from the crowd at Dublin Castle when they displayed the sign, "The North is next". When considering and making progress on this legislation, I encourage the Government and colleagues in the Seanad not to forget the North and ensure Irish women, whether in Derry, Newry, Enniskillen or Belfast, will not have to travel as far as they once did.It is about showing the necessary compassion, care, understanding and acceptance of the realities that exist. When we bring forward legislation, which I hope will afford women the right to choose what to do with their own healthcare and bodies, we should ensure the right is afforded to women as best as possible right across the Thirty-two Counties. We have the opportunity to put practical measures in place that will assist women. It is not good enough. It is not where we want to be. I sincerely hope that in both the conversation surrounding the issue and its delivery, the North will be next. If that does not come to fruition, it is vitally important we enable women across Ireland to avail of healthcare in the circumstances in which they need it.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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Well said.

Photo of Aodhán Ó RíordáinAodhán Ó Ríordáin (Labour)
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I thank the Minister of State for being here. This is an emotional day. I share the emotion of my colleague and friend, Senator Humphreys, when he apologised. I feel the same need to show a sense of shame as an Irish man for what has been done to Irish women and continues to be done to them to this day. I join others in commending my colleague, Senator Bacik, who for years has campaigned on this issue. It was often a very lonely struggle, both inside and outside the Labour Party, to convince people like me and the people of Ireland of the great wrong that was done in 1983. She has been threatened with jail and received all sorts of vile communications over the years but she has never resiled from her absolute belief in the necessity for the Republic to live up to its name and deliver on gender equality in every single aspect of life.

I am tempted to be drawn into making this debate about the men of the "No" campaign who continue to utter misogynistic comments to try to shame and misrepresent what the vote of the people was about. We saw the antics in the Dáil. We have begun to hear unfortunate language being used again today in this Chamber. This cannot be about the men of the "No" campaign no matter how much they want to make it about them and how upset they are that their life's work is crumbling before their eyes. This has to be about the women of Ireland, the mistakes we have made, the shame we have thrust upon them and the journeys we continue to force on them. I can only speak as someone who is proud to stand in the Oireachtas today and feels a sense of the washing away of the sins of the past. Perhaps we did not know the country very well. I do not know if people in the Chamber have begun to look at their country and all the things we thought we were. We are now not what we thought we were. In Europe and the world, when we look left and right, we observe Brexit, Trump and the rise of right-wing populism across Europe. We thought our country was a conservative backwater that would never embrace the idea of LGBT rights, women's rights or reproductive rights and would never descend to racist race card immigration debates at a time of election. In some bizarre way, the island I grew up on in the 1980s is a beacon of light for progressive minded people across the world.

I will never know what it is like to be pregnant. I know people who I love deeply who have gone through pregnancy and I suggest it is the most profound thing any woman will go through. It takes over one's body, mind and spirit. It dominates every ounce of one's being for nine months until birth and every waking moment after that. It is monstrous, and has always been monstrous, to suggest one would take that decision lightly, that women take it lightly or should go through it, or be forced through it, against their will.

I do not intend to speak on every Stage of the debate. I do not intend to say more. I do not want to lengthen the debate because we have debated it inside and out. Many people have been discussing it for 30 years. Some of us are newer to the debate, having joined it over the past number of years. The country went through it in May and made its decision clear. There are elements of the Bill I am not comfortable with. The three-day waiting period is an insult to women but it was part of the debate on the referendum. If it was part of the debate in the referendum and people voted "Yes" on that basis, it has to be in the Bill. We can amend it at a later stage.

I have a seven month old girl called Anna. She has now been born into a republic where she is something approaching less than a second class citizen. She is now a full citizen of this Republic. She has absolute autonomy over her own body to do what she will with her own body at any stage of her life. On her behalf, because she cannot speak yet, I thank Members of the Oireachtas, citizens, young and old campaigners and, particularly, the young women with Repeal jumpers who were derided by media outlets and seasoned journalists who thought they knew it all. They said it was not the way Irish politics worked and that these young women did not understand Ireland or its nature. It was fearless, compassionate and determined - mostly young - women proudly displaying their Repeal jumpers who changed the country and possibly made the entire world look at itself and this country in a different light. I say well done to them. I am proud to live in a country with them. Let us get the legislation passed and ensure we do not wake up on a day in January on which another 12 women have to make the lonely Ryanair journey to England to get what they deserve in their own country.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Senator Nash has eight minutes.

Photo of Gerald NashGerald Nash (Labour)
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I will not use eight minutes but I will place on record my gratitude to the people and women of Ireland for ultimately making the right decision last May. That day last summer was a momentous and historic day. It marked a milestone on the road to the Republic becoming a much more pluralistic, tolerant and open society. As my colleague, Senator Bacik, stated earlier, we must reflect on the at least 160,000 Irish women who we banished from these shores in the past few decades. They were women who could not access a service they should have been entitled to receive in this country. They were denied a public health service which it should have been their right to have.

The legislation allows us to consign a very dark chapter in our history to the historical dustbin. In saying that, I pay tribute to my friend, comrade and colleague, Senator Bacik. I listened intently to her emotional contribution. She will not mind me saying that. I understand why it was emotional because, more than most, Senator Bacik has the metaphorical scars on her back from fighting the right campaign for many decades. I was struck by the words of Senator Kelleher. I remember when we were debating the draft legislation to allow the referendum to take place in a late night sitting last spring during which many people had the opportunity to speak. Senator Kelleher reminded the House of the long relationship she had with Senator Bacik in supporting and giving succour and comfort to young Irish women in crisis who had to travel to the UK back in the dark days when Senator Bacik was leading the students' union in Trinity College and selflessly put those women first at great risk to herself and her liberty. We should be reminded of that. Are there many people in the Houses who would take those risks for something they believe in? I sincerely doubt it.I think it is telling that those on the anti-choice extreme of this most personal of debates in this House rarely concern themselves with the concerns that most of the rest of us express around child poverty, deprivation, marginalisation-----

Photo of Gerald NashGerald Nash (Labour)
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-----and the actual rights of women, whether it be gender pay, women's rights in the workplace and society, and reproductive health. We rarely, if ever, hear any mention from those who stood up here today and in the Dáil over the past few days about those real, everyday issues that are evident all around us. Time and again, those people are quick to judge women in crisis and tell women how they should run their lives. As an Irish man, I object to that. I have no right to do that. We are thankfully introducing legislation that will reflect the views expressed by the vast majority of Irish people, up and down this country, north, south, east and west. This society needs to change and is changing.

My involvement in the Together for Yes movement was inspiring and emotional. Senator Bacik was in my constituency office last Monday and there is a little hall in that office that we made available for the very first cross-party and cross-community Together for Yes meeting in Drogheda. It was packed to the rafters. We did not even have to promote that meeting, just word of mouth got around that that meeting was taking place. A bunch of people, of all political persuasions and none, came together to unite around this issue to make Ireland a more tolerant, pluralist and better society. We did that together by speaking with a democratic voice at that referendum last summer. We have an obligation now to legislate to give voice to that historic decision. I am grateful for being a Member of this Oireachtas with that obligation and responsibility.

I also thank Senator Noone for the role she played in her expert chairpersonship of the committee. That will go down in history and she can be proud of the role she played, as can many people in this Chamber and across the Oireachtas.

Photo of Gerald NashGerald Nash (Labour)
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It is a momentous milestone in our maturity as a republic and pluralist society. I am pleased, honoured and privileged to have a role in legislating to give effect to the decision of the Irish people last summer.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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I thank Senator Nash for his kind words which are very much appreciated.

Photo of James ReillyJames Reilly (Fine Gael)
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I commend Senator Noone for all the work she did on a very difficult issue in committee. I do not wish to delay the passage of this Bill by as much as five minutes if I can help it. Every day, eight women travel from this country and another three take medicine acquired over the Internet and they do so without the support they deserve and need and that we are obliged to give. The Irish people have spoken and it is up to us to now ensure their words are put into action.

There are many elements to this Bill and I welcome the fact that it vindicates the rights of women. Over the past five years, we have seen significant social change at a time of great financial difficulty. There was the marriage referendum. We have effectively banned corporal punishment everywhere now with the removal of reasonable chastisement as a defence. Now we have this Bill as well. I welcome it. I appeal to those who are keen to see this Bill pass not to make amendments because if amendments are carried in this House it will have to go back to the Dáil and further delay this essential service for women. Senators will feel the need to speak and I welcome that because this is democracy, but I hope people will bear in mind that every day before this Bill passes, another 11 women are disadvantaged.

There is one element I want to speak to as a doctor because I believe very strongly in the right of conscientious objectors not to be forced to do something that is against their conscience. I respect those people. It is not my position, but I do not want to see doctors bullied or vilified because of a position they hold. I do not want doctors or junior doctors bullied or vilified by older doctors who might take a different opinion to them, one way or the other. Much of this care is going to take place in general practice where there are many group practices with young doctors who might not share the view of the senior person in the practice. That has to be respected.

Senator Norris contended that we should have clinics. I would not have any problem with that, but this is an all-Ireland, 26-county service, and there would not be clinics in places like Belmullet or various other far flung places with small populations. People are entitled to their privacy. They do not want to go to a clinic and have reported back they were seen at "the clinic". We strived to destigmatise mental health by having all our facilities in the one place and I was very happy to open the new primary care centre in Balbriggan yesterday. There are wonderful child and adolescent mental health and adult psychiatry services there. People walk in the same door as any other patient and it is their business to have their needs met locally, the same way as someone with chest pain or a broken ankle.

I listened to Senator Mullen, who made some very strong points, but I think it was grossly unfair of him to make a comment that the Minister is not here when he knows full well the Minister has gone to an important meeting in Brussels at a critical time in this country's history as we face into Brexit.

Without further delay, I welcome the Bill. I will not echo all the other comments made. I would thank all those here in the House, and those who are not here anymore, who have striven over the years to reach this point. I commend them, but mostly I commend the women of Ireland.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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It would be remiss of me not to begin by thanking Senator Noone for the work she did with the committee, and all the people who sat on the committee. I also thank the people who, on both sides, spoke at times with great emotion. Behind all the emotion, the debate was really about the health and well-being of our society. No matter what side one was on in this debate, it is important to acknowledge that people were full of emotion and only wanted what was best. That is my small contribution.

Unfortunately the Minister for Health, Deputy Harris, has gone away so I have been asked to read concluding remarks. I would like to begin by expressing both my own thanks and those of the Minister to the Members of the Seanad who have contributed on the Second Stage debate on the Health (Regulation of Termination of Pregnancy) Bill 2018. We all recognise there are deeply held views on all sides of this Oireachtas and throughout the country and, in taking the next steps as a Parliament and a Government, it is important that we respect and hear all those views. We have agreed that, no matter what divides us, we are united by wanting to do what is right.

I support the Minister in his commitment to introduce the legislation and echo his statement that it is a priority for this Government to have medically-delivered, safe and regulated services for the termination of pregnancy for all those who require it. The Department of Health is engaged with the medical community to develop and deliver women's services to effectively operate the legislation and ensure that women can access the healthcare they need.

I want to make it clear, however, that we are also taking seriously the ancillary recommendation made by the Joint Committee on the Eighth Amendment of the Constitution. I wish to assure Members again that the Government is committed to working to reduce the number of crisis pregnancies and that this is part of the ongoing work of the Department. The publication of the first National Sexual Health Strategy 2015-2020 provided the opportunity to ensure that all efforts across the entire range of sexual health, including awareness, education, training, access, treatment and surveillance are co-ordinated, evidenced, informed and based on best practice.

The strategy was developed around three goals. Everyone in Ireland will receive comprehensive and age-appropriate sexual health education information and will have access to appropriate prevention and promotion services. Equitable, accessible and high-quality sexual health services, which are targeted and tailored to need, will be available to everyone. Robust and high-quality sexual health information will be generated to underpin policy, practice, service planning and strategic monitoring.The HSE sexual health crisis pregnancy programme is committed to implementing the national sexual health strategy with statutory and non-statutory partners to improve sexual health and well-being and reduce negative sexual health outcomes. Work has been progressing on the development of the more comprehensive sexual health and well-being education, information and promotion programme.

Progress in recent months includes the formal launch and ongoing development of the new website, www.sexualwellbeing.ie, which provides information on contraception, crisis pregnancy, consent, relationships and sexually transmitted infections. A new safer sex campaign targeted primarily at young people was also launched recently using the hashtag #RespectProtect. The campaign actively encourages people who are thinking of having sex or a sexual activity to think ahead, access correct information and practise safe sex. It continues to focus on the importance of using condoms both to prevent unwanted pregnancy and to protect against sexually transmitted infections. The campaign provides the HSE with greater flexibility in conveying more targeted and credible safer sex messages to a younger audience. There is also ongoing extension of the provision of free condoms to targeted harder to reach groups, including, for example, people living in direct provision.

The Government is also working to improve the position for women more generally. The national strategy for women and girls, NSWG, was launched in 2017 and is led by the Department of Justice and Equality. The NSWG is the framework by which the Government is pursuing actions to advance the rights of women and girls and to enable their full participation in society. Objective 2 of the NWSG is to advance the physical and mental health and well-being of women and girls. Under this objective, the HSE and Department of Health are working with the National Women's Council of Ireland to develop a women's health action plan.

I assure Senators that the Government is working to put women's health at the forefront of our priorities. I agree with the Minister that everyone needs to work together on this legislation in order that we can put services in place for women who need them as soon as possible. I look forward to a time when women can be assured that they will be able to access all the care they and their families need in this country.

I am mindful, however, that issues have been raised around some provisions in the legislation. The Minister plans to be here next week to discuss and address these concerns in greater depth. I thank Senators again for their contribution to the Second Stage debate. The Minister looks forward to further constructive examination of the Bill on Committee Stage.

Question put:

The Seanad divided: Tá, 30; Níl, 3.



Tellers: Tá, Senators Gabrielle McFadden and James Reilly; Níl, Senators Rónán Mullen and Brian Ó Domhnaill..

Question declared carried.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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For the fifth time this week we have had a problem with the result of a vote. Either Senators did not vote or they voted at the wrong chair. This is probably not appropriate but it reminds me of the Old Testament and the parable of the wise and foolish virgins. Those who were ready for-----

Photo of David NorrisDavid Norris (Independent)
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There are no virgins here.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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-----the Lord were ready. In future I will take a dim view of Senators who do not vote or vote in the wrong place and I may exclude them, but I accept the amended result of the vote.

Committee Stage ordered for Monday, 10 December 2018.