Rónán Mullen (Independent)
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I welcome our guests in the Gallery. The much anticipated report from the three-year review into Ireland's abortion legislation was released on 25 April. Before its official release a series of leaks to The Irish Timesindicated that the report would recommend sweeping changes to abortion law. These leaked reports seemed to confirm what many people feared, which is that the eventual recommendations would be radical and entirely one-sided. From the word go, all signs suggested the review would be anything but independent. In summer 2021, the Minister for Health, Deputy Donnelly, met a selective group of people who all think and thought virtually the same things about abortion. They were all brought together by the National Women's Council. These included groups such as the Abortion Rights Campaign, the coalition to repeal the eighth amendment and other similar groups. There was no interest, of course, in talking to those who would wish to see the unborn protected in whatever way was possible under the new law.

In December 2021, the Minister promised that the so-called independent chairperson to lead the review would be appointed by public tender. We know this did not happen because it was done without a public tendering process and the person appointed was someone who had skin in the game, so to speak. It was a person who had been on the record in social media on the pro-repeal side. The question of independence was finessed by Government supporters suggesting that all that was meant by "independent" was somebody who was not in the Government, and was independent of the Government and the Department.

This spin raised questions about the integrity of the process from the start and about the professionalism of the people driving the process. It was no surprise to see many major shortcomings in the report, quite apart from the extreme nature of its recommendations. For instance, and remarkably, on page 6, the author of the report writes that between the beginning of January 2019 and the end of December 2022, there had been approximately 17,820 abortions. While she acknowledged in a footnote that these figures might not be accurate, she then failed to do the work required to calculate an accurate figure. Last year, the Department of Health acknowledged there were an extra 2,000 abortions in 2021. Similarly the report chairperson failed to include a staggering 8,500 abortions in 2022, which the Minister revealed in an impromptu radio appearance.

This supposedly independent chairperson produced a report that underestimated the total abortion rate by approximately 40%. Factual errors such as this are just not acceptable. The report and the review should have examined the startlingly high abortion rates we have had in just four years. There was only cursory treatment, and no interest in evidence-based analysis, on the issues of the necessity for precautionary pain relief for the unborn.On the issue of the three-day waiting period, she relied on activist research designed to minimise the number of women who opted not to have an abortion having had the first consultation. She came in with the remarkably low figure of 2% but could have relied on the HSE figures, released in reply to questions in the Dáil, which show that as many as 4,000 of the approximately 30,000 women who had abortions in recent years may have changed their minds. Even allowing for miscarriages and some women possibly having gone elsewhere for an abortion, that would indicate a figure of approximately 17%. It is an issue of integrity - the integrity of the Minister and the Department.

I do not necessarily blame people who have particular views for accepting an appointment to organise and produce a report that is supposed to be independent, but they have to be judged by what they have produced. Everything in this report suggests extreme bias. There is a failure to examine the issues that might suggest there is something wrong with the way the abortion law is operating, with such an increase in abortion rates, and a desire to bolster the case for removing the three-day waiting period.

In light of all that, I am not surprised that the Minister of State, Deputy Niall Collins, has been left to take this Commencement matter. I am not blaming him. The Department of Health and the Minister run away from the hard questions about abortion and the way the abortion law is acting. It is disgraceful. It lacks integrity and is unprofessional. I do not blame the Minister of State, Deputy Collins, for that but I do not anticipate any great humility in the words that have been prepared for him to deliver in respect of this appalling report.

Niall Collins (Limerick County, Fianna Fail)
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I thank the Senator for raising the issue. As he noted, I am responding on behalf of the Minister for Health. I am grateful for the opportunity to address the House on the review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018. As the Senator is aware, the Minister for Health commenced the review of the operation of the Act in line with statutory and Government commitments at the end of 2021.

The review was based on wide-ranging independent research and comprised two phases. The first phase was an evidence- and information-gathering exercise which consisted of a public consultation, as well as research into the operation of the Act from the perspectives of service users and service providers. The public consultation provided organisations, stakeholders, advocacy groups working in the area and all other interested parties with the opportunity to have their say on the operation of the legislation. Nearly 7,000 submissions were received as part of the process. Research to inform the service user strand was carried out by Dr. Catherine Conlon, who has completed a large qualitative study investigating unplanned pregnancy and abortion care. This study, commissioned by the HSE’s sexual health and crisis pregnancy programme in September 2019, has generated an in-depth understanding of the experiences of women who have accessed abortion care services since the commencement of the Act. The study was published by the HSE on 12 July 2022. Research into the views and experiences of termination of pregnancy service providers was carried out following a tendering process by Manchester Metropolitan University. The second phase of the review was led by an independent chair, Ms Marie O’Shea BL, who assessed the extent to which the objectives of the 2018 Act have been achieved, analysing in that regard the findings of the three strands of information from the first phase. The chair also drew on the findings of other relevant peer-reviewed research and consulted further with stakeholders as necessary before providing conclusions.

The final report of the review was submitted to the Minister for Health on 28 February 2023. The report makes a range of recommendations, most of which are operational in nature, with some proposing legislative change. The report was considered by the Cabinet on 25 April. The Government agreed that the HSE will establish an implementation group to progress the operational recommendations. As regards the proposed legislative changes, it was recognised that they will require careful contemplation and discussion to ensure they secure as broad a support base as possible. Therefore, the Minister for Health, with the approval of the Government, has referred them for consideration and report by the Oireachtas Joint Committee on Health. Given the committee’s cross-party composition and oversight role in respect of the health service, it represents an effective and appropriate forum to consider the changes proposed.

Rónán Mullen (Independent)
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A pro-repeal chairperson, with pro-repeal activist research also cited by the Minister of State, relying on a study based on a very small sample from a group of pro-abortion doctors rather than relying on HSE data provided in reply to questions in the Dáil, does not sound like wide-ranging independent research. The report chairperson was quick to cite evidence internationally in favour of removing the waiting period but ignored other countries that have waiting periods. For example, Belgium, which is hardly a conservative country, has a six-day waiting period. There was no interest at all in that side of the argument. Some people are tired of people with no fairness, scruples, ethics or professionalism driving analysis on how the new abortion law is working. Two things are clear. First, abortion rates have gone up dramatically and, second, some abortions are taking place in late term, with no consideration of precautionary pain relief for the unborn involved. That is savage. The Government and all those who turn a blind eye or advocate this kind of public health policy ought to be ashamed of themselves.

Niall Collins (Limerick County, Fianna Fail)
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As the Senator is aware, the Minister for Health commenced the review of the operation of the 2018 Act in line with statutory and Government commitments. The review was led by the independent chair and based on comprehensive independent research. The Minister received the final report of the review at the end of February and it was considered by the Government on 25 April. In line with the Government decision, the HSE will now proceed to progress the operational recommendations in line with the report, while the recommendations involving legislative change will require further consideration by the Oireachtas Joint Committee on Health.