Health (Family Planning) Bill, 1978: Second Stage.

Minister for Health (Mr. Haughey)

I move: "That the Bill be now read a Second Time."

I believe that Deputies recognise the importance of this measure. It is a Bill designed, after lengthy consideration and wide consultation with interested parties, to deal in a responsible and acceptable way with a problem which has been a matter of political debate for the last six or seven years but which has not so far been resolved. It is a Bill which follows a Supreme Court decision which involved a fundamental change in the law relating to the availability of contraceptives.

The Government decided, when introducing the legislation made necessary by the Supreme Court decision, to avail of the opportunity to legislate also for a full family planning service. As a result, we have here the first real Family Planning Bill to be introduced since this matter first became the subject of controversy in this country. The Bill introduced by the last Government in 1974 specifically related to the control of the importation, sale and manufacture of contraceptives and the consequential amendment of certain legislation affected by the provisions of that Bill. Other Bills which were introduced in the Seanad were entitled Family Planning Bills, but were primarily designed to control the importation of contraceptives in much the same way as the provisions set out in the Bill introduced by the last Government. The Bill now before the House genuinely merits the title of Family Planning. Its emphasis is primarily on the provision of family planning services and it deals with the control of contraceptives as something which, apart altogether from the Supreme Court decision, must be dealt with in the context of a comprehensive family planning service. It is because this Bill is a Family Planning Bill in the full and proper sense of those words that I am commending its provisions to the House. I hope that when it has been fully considered and discussed, its enactment will bring an end to the controversy about what we should include in our family planning legislation so that we can get on with the task of seeing that appropriate family planning services are available to those who wish to decide in a responsible way on the size of their families and the intervals at which they hope to have children.

I propose later to deal with the specific provisions of the Bill but before I do so I should like to comment on the unfounded criticism that the Government is unnecessarily introducing legislation legalising the sale of contraceptives and that it is wrong for it to do so and that other courses of action are open to us.

By way of reply, I feel I should begin by outlining the position that currently obtains in relation to the availability of contraceptives. As Deputies will know, the importation of contraceptives into this country was governed by the provisions of section 17 of the Criminal Law (Amendment) Act, 1935. That law made it unlawful for any person to sell contraceptives, or to import them for sale, and it also included contraceptives in the list of items whose importation into this country was prohibited under the Customs Acts. The net effect of this legislation was that contraceptives could not legally be imported into the country and that the sale of contraceptives in this country was also made unlawful.

This was the position which obtained from the passing of the 1935 Act until the judgment which was given in the Supreme Court in what has come to be known as the McGee case. In that judgment it was held that section 17 (3) of the Criminal Law (Amendment) Act of 1935 was unconstitutional and, therefore, of no effect. There was no declaration made in the judgment in relation to subsection (1) of the section which prohibited the sale or import for sale of contraceptives. The net effect of the decision, therefore, was that there has not been, since the judgment was given, any control over the importation of contraceptives and that it is, at present, legal for any person, irrespective of his or her age or marital status, to import contraceptives provided they are not being imported for subsequent sale.

That in brief is the current legal position. It should be clearly understood by everybody what the present situation is and that this Bill is not for the first time legalising the availability of contraceptives. At present, contraceptives are legally available to anybody who wishes to import them and I would suggest to those who criticise the provisions of this Bill that they should, in doing so, have regard to the present factual position in relation to the availability of contraceptives. The effect of the Bill, which I am now introducing, is generally to control the availability of contraceptives and restrict effectively their supply to certain authorised channels for family planning purposes.

Before introducing a major Bill of this nature, dealing with a matter which has been the subject of concern and controversy for so many years, I deemed it prudent to make every effort to inform myself in so far as this could be done, of the views and attitudes of those professional bodies who would be affected by the provisions of family planning legislation, the health boards, Church leaders, and all those community organisations, vocational bodies and individuals who could help to convey to me the range of views held throughout the community on this important issue.

During the consultative process, over eighteen organisations agreed to come and discuss with me the provisions which might appropriately be included in a family planning Bill. Those organisations which came to me had clearly spent a great deal of time in considering the question and I should like to take this opportunity of paying tribute to the co-operation which I received, not only from those bodies with whom I met, but also from a number of other organisations which wrote to me to indicate their views on this most important subject. It would not, I think, be appropriate for me to attribute specific recommendations to specific bodies since the discussions which took place were on a confidential basis and were primarily intended to assist me in arriving at the decisions which had to be made. Nevertheless, it would, I think, be of assistance to Deputies if I were to indicate broad areas on which there was a general consensus among those organisations which made their views known. Where such consensus existed among a clear majority of those consulted I have had regard to this in the preparation of the legislation.

It should first be made clear that there was a general consensus that family planning, in the sense of deciding upon the number and spacing of children, was something which was regarded as being highly desirable. There was also general agreement that responsible decisions in relation to family planning could only be taken by those who had available to them adequate information about the various methods of family planning. Health boards unanimously were of the opinion that the provision of such advice and information was an appropriate function for the boards, but the majority of the boards did not consider that it would be appropriate for them to be the providers of contraceptives.

All the bodies consulted by me agreed that there was a need to legislate in relation to family planning and contraceptives. None of them suggested that the existing legal position was desirable or should be allowed to continue; most of them took the view that the present position, which allows any person to import contraceptives for his own use, but in which they cannot be sold, should not be allowed to continue. It emerged clearly that the majority view of those consulted was that any legislation to be introduced should provide for a more restrictive situation in relation to the availability of contraceptives than that which exists by law at present. In putting forward this view, most of those who did so recognised the practical difficulties of implementing restrictive legislation but still felt that legislation which was, on the whole, restrictive in relation to the availability of contraceptives should be attempted. The general view was to the effect that the availability of contraceptives through a large variety of sources and, for example, from slot machines and similar dispensers, should not be tolerated.

The discussions in which I engaged were extremely valuable to me in that a number of specific issues were clearly defined as being of fundamental concern to many of the organisations involved in the discussions. There was, for example, general agreement that advertising of artificial contraceptives should not be permitted in journals or newspapers in general circulation. The majority view was that information about specific methods of artificial contraception should be made available through their professional journals to doctors and nurses and to other persons who are engaged in providing advice and information about family planning. Many of the bodies concerned have drawn my attention to the fact that advertising of contraceptives is taking place in magazines in public circulation in this country and, arising out of such representations, I have made appropriate provision in the Bill to deal with this matter.

A major issue, on which there was unanimity among those consulted and to which almost all of them referred, was the question of abortion. I assured all those with whom I had consultations that it was my intention to include in the Bill a specific provision making it clear that abortion would not be contemplated in any legislation which I would be introducing.

I also mentioned, during the course of my consultations, the desirability of providing in a family planning Bill a section which would enable those who had conscientious objections to being involved in any legislation relating to contraception and contraceptives to opt out of the operation of such legislation. In fact, prior to the commencement of discussions with the organisations which I met, I had made it clear in my Department that officers who had a conscientious objection to being involved in the preparation of the legislation would not be required to participate in it. The fact that I was willing to include such a provision in the legislation was welcomed by the majority of the organisations since they were concerned to ensure that anyone who was unwilling to be involved in legislation which related to contraceptives should not be required to be involved in its implementation.

There were other matters which were raised during the course of my consultations. Many of the points made are reflected in the provisions of the Bill; some of the points which were raised did not require to be mentioned specifically in this legislation since I already had power, either in earlier Health Acts or in other legislation, to implement recommendations made. In turning now to the detailed provisions of the Bill, I propose to refer, where appropriate, to the representations which were made to me and to the extent to which they have influenced the manner in which this Bill is now being presented to the Dáil.

Section 1 contains definitions which have to be borne in mind in considering the provisions of the Bill as drafted. It will be noted that there is no definition of "the Minister" in these definitions. Specific provision for such a definition is not needed in this Bill since it will be cited as one with the Health Acts and it is made clear in those Acts that the Minister referred to is the Minister for Health. I should, however, like to make the point that this legislation is being introduced by me, as Minister for Health and not, as with the previous Government's Bill on this matter, by the Minister for Justice. The Government decided, in considering the procedure to be followed in introducing family planning legislation, that it was appropriate that such legislation should be introduced by the Minister for Health and that contraceptives should be brought within the ambit of health legislation rather than retained in the context of the criminal law. The decision is one which makes clear the Government's concern that family planning, in the broad sense of that term, should be seen as part of the general health services.

I should like to draw attention specifically to one definition in section 1. It may be necessary to do this in order to avoid the possibility of confusion during discussions on the Bill. Deputies will note that the definition of "family planning service" means a service for the provision of information, instruction, advice or consultation in relation to any one or more of the following: (a) family planning; (b) contraception; (c) contraceptives.

Family planning services, as so defined, relate only to the provision of information, instruction, advice or consultation and do not include making contraceptives available. The sale and supply of contraceptives is dealt with separately and specifically in section 4 of the Bill, which sets out all the circumstances in which contraceptives may be sold or supplied to members of the public.

Section 2 imposes on the Minister the duty to secure the orderly organisation of family planning services and to provide a comprehensive natural family planning service. The situation at present is that family planning services are available only on a limited basis. In some areas, contraceptives are being made available, very often illegally. In so far as advice and instruction is concerned, these are, to some extent, available through family doctors, maternity hospitals and clinics and through family clinics established under the aegis of the Family Planning Association. It will be the responsibility of the Minister for Health in the future to arrange that family planning services, as defined in the Bill, are made available on a more general basis throughout the country. This will necessarily involve a review of existing services and I intend to seek the co-operation of the medical and nursing professions in deciding the form and extent and the detailed arrangements for a new comprehensive service.

Section 2 also requires the Minister for Health to provide a comprehensive natural family planning service. This provision has been inserted in the Bill because I am convinced of the value and importance of providing such a service and, furthermore, because during the consultations it was made clear to me that there was a general desire that advice and information about all methods of family planning should be generally available.

There are a number of agencies which are currently providing advice and information about natural methods of family planning. The National Association for the Ovulation Method in Ireland are in course of providing an extended service throughout the country and, in discussion with me, indicated that, with support, they would be in a position to expand the service which they are currently making available in specific areas. The Catholic Marriage Advisory Council are concerned also with this problem of providing and extending the availability of information and advice about natural methods of family planning.

Deputies will be aware that the World Health Organisation is currently undertaking a study of the acceptability of natural methods of family planning and of the extent to which they can enable people to regulate the size of their families. This country is participating in this study but it will be some time before the results are available.

Later this year, I am arranging to hold, with the assistance of the World Health Organisation, an international seminar on natural family planning in which leading world authorities will participate and during the course of which the latest developments in natural family planning methods will be reviewed and discussed.

When the Bill has been passed, I propose to work closely with NAOMI and with the Catholic Marriage Advisory Council and to obtain their assistance in providing a comprehensive natural family planning service so that in coming to a decision about the manner in which they wish to plan their families, couples have available to them appropriate advice and information on this method of contraception in addition to other methods and that there will be available to them, if they desire to utilise this method, informed guidance and assistance in doing so.

Under section 3 the Minister for Health is empowered to make regulations relating to the making available by a health board of a family planning service. Here I would refer again to the point I made on section 1, that is, that a family planning service, as defined in the Act, does not include the provision of contraceptives. This accords with the view put forward to me by the majority of health board representatives that they wished to provide a wide-ranging and comprehensive service of advice and instruction on all methods of family planning but that they did not feel it appropriate that health boards as such should be involved in the provision of contraceptives. Those bodies which are providing advice and instruction only in relation to natural methods of family planning are excluded from the provisions of the section.

The section also empowers the Minister for Health, when satisfied that it is in the public interest to do so, to consent to the provision of a family planning service by other bodies.

Where instruction or advice in relation to methods of family planning which involve the use of contraceptives is given, this can be done only under the general direction and supervision of a registered medical practitioner. In such circumstances, advice and information about natural methods of family planning must also be available.

I should like to draw particular attention to the fact that nothing in the section relates to or is intended to restrict the discretion of a registered medical practitioner in his clinical relations with a patient. It is a matter entirely for the discretion of the medical practitioner, consulted by his patient, to decide what advice is appropriate in the circumstances, what method or methods of family planning are appropriate in the circumstances of a specific consultation and to act according to his clinical judgment in relation to the provision of advice and guidance in any particular case.

Section 4 provides that contraceptives shall be sold only by chemists in their shops and that they shall be sold only to persons named in a prescription or authorisation given by a registered medical practitioner. The section requires that the medical practitioner be of the opinion, when giving the prescription or authorisation, that the person requires the contraceptives for the purpose, bona fide, of family planning or for adequate medical reasons and in appropriate circumstances.

The provision is the outcome of long and earnest consideration of the different ways of providing for the availability of contraceptives. It is clear to me from my consultations that majority opinion in this country does not favour widespread uncontrolled availability of contraceptives. The view was also expressed frequently that the existing position in relation to the supply of contraceptives is unsatisfactory in that it makes contraceptives available without any form of control to anyone, child or adult, single or married, who wishes to write away and import any form of contraception they wish.

It becomes increasingly clear to me as the consultations and the discussions went on that I should aim at relating the availability of contraceptives to genuine family planning. There is, as I have said, a majority opinion that family planning is a necessary and desirable objective of health services and there is also an opinion that, in the attainment of the objectives of family planning, it is desirable that information and advice be available about all forms of contraception. The Supreme Court also has indicated that families, in arriving at decisions about the methods by which they plan their families, should not have those decisions impeded by the action of the State.

In these circumstances, it seemed to me most appropriate that the responsibility for providing guidance and assistance in relation to decisions on family planning and for authorising the provision of contraceptives, where these were appropriate in the family planning context, should reside with the family doctor. At present, the family doctor provides a general service for parents and for members of the family. He is currently, in many cases, asked for advice on appropriate methods of family planning where parents wish to limit or to space the number of their children. He is the person who most appropriately can give such advice and assistance since he is the professional person who knows most about the physical and psychological characteristics of the couple seeking his advice and who is also aware in a general—or frequently in a very specific way—of their social and financial circumstances. No other single professional person is as well qualified as he to advise on appropriate methods of contraception where such advice is sought by a patient.

The Bill, therefore, places family planning firmly in the context in which, I believe, it should be placed, that is, in the context of family medical care provided by the general practitioner. This seems to me to be a wise and sensible way to ensure that the making available of contraceptives will be for family purposes and will be accompanied by advice regarding the merits and the hazards of different forms of contraception. The provision in this, and the preceding sections, should, in my view, ensure the availability in this country of an adequate family planning service under the general direction and control of those who are in the best position to advise about the manner and extent of the provision of such services in individual cases.

Section 5 of the Bill provides for controlling the importation of contraceptives into the State. There is provision for the importation, in personal luggage, of limited quantities of contraceptives required by a traveller for his own use. Apart from this exemption, contraceptives may be imported only under licence to be granted by the Minister. Licences may be granted to wholesalers who wish to import contraceptives for sale to pharmaceutical chemists or a licence may be granted directly to a pharmaceutical chemist. The importation of contraceptives otherwise than in personal luggage or in accordance with the licence granted by the Minister is, in effect, prohibited by subsection (6) of the section.

The manufacture of contraceptives may not take place except under licence granted by the Minister under section 6 of the Bill. The licence may be granted if the Minister is satisfied that the contraceptives being manufactured will be sold to pharmaceutical chemists or may be granted directly to a pharmaceutical chemist. I have included this provision not because I think it likely or desirable that Irish industry should become involved in the manufacture of contraceptives but simply as a "safeguard" measure.

The effect of sections 4, 5 and 6 together is to create a situation in which the importation of contraceptives and their manufacture in the State will be strictly controlled and the sale of contraceptives will take place only in pharmacies and in accordance with prescriptions or authorisations issued by registered medical practitioners. It will be necessary for a practitioner to issue a prescription for the pill since the sale of anovulents is governed by the provisions of the Medical Preparations (Control of Sale) Regulations, 1966.

In so far as other contraceptives are concerned it will be open to the medical practitioner to provide his patient with an authorisation to obtain such supplies of specified contraceptives as he considers are appropriate in the patient's particular circumstances. Sale by a pharmacist would be restricted to the person named in a prescription or authorisation.

As I mentioned earlier, one of the matters which emerged very clearly and on which there was a general consensus was that there should not be unrestricted advertising of the availability of contraceptives in newspapers and magazines. Section 7 provides that the extent to which advertising in relation to contraception or contraceptives may take place is to be determined in regulations. My intention is that the regulations would restrict the advertisement of contraceptives and techniques of contraception to doctors, nurses, chemists and other persons engaged in the provision of family planning services. Section 8 makes it an offence to forge a prescription or authorisation or to be unlawfully in possession of such a forged document.

I have provided, in section 9, power for the Minister to make grants to a person to finance research into methods of family planning that do not relate to the use of contraceptives. It was represented to me by a number of bodies that research into methods of natural family planning and studies of the outcome of trials of methods of natural family planning were inhibited by an acute shortage of money. At present, such activities are in this country undertaken by voluntary bodies and these have found that their financial resources were inadequate to permit them not alone to extend their activities but also to evaluate those activities and to report on the efficacy of the methods which they were supporting. It is, I think, reasonable that such efforts should be given financial assistance to enable them to play their appropriate part in the general context of family planning services.

I consider it essential to make it clear that this Bill sets its face unquestionably against weakening of the position in regard to abortion. Section 10 of the Bill specifically states that the Act does not authorise procuring abortion, the use of instruments or drugs to procure abortions, or the sale, importation into the State, manufacture, advertising or display of abortifacients.

In section 11 I have made it very clear that no person will be required under the provisions of the Bill to take part in the provision of a family planning service, to give a prescription or authorisation for the purposes of the Act, or to be involved in the sale, importation, manufacture, advertising or display of contraceptives.

I know at this stage that there is throughout the country as a whole a wide general acceptance of the desirability of family planning and of the need to have available for families a satisfactory family planning service. The majority of couples wish to be in a position to take informed and responsible decisions about the size of their families and the spacing of their children. For this purpose they consider it necessary to have at their disposal up-to-date and comprehensive information about the various methods of family planning and, relying on that information, to decide on the means of family planning which is most appropriate to their circumstances.

There are many others who, while they accept the desirability of family planning, would not in the determination of the size of their own families wish to avail of any other than natural methods. Similarly there are those employed in the health and ancillary services who would not wish to be associated with either the provision of information or with making available means of family planning other than natural ones. Under section 11 there will be no compulsion on anybody to use any part of the family planning service to which they have an objection or to be involved in the provision of information or advice about any aspect of family planning to which they have a conscientious objection.

The purpose of section 12 is to amend the Censorship of Publications Acts to take count of the fact that this Bill will authorise the provision under certain circumstances of artificial methods of contraception. The amendments are essentially consequential ones in that it would be unrealistic and illogical to provide in the Bill for the availability under certain circumstances of artificial methods of contraception and to continue to ban books which advocated or referred to such methods.

Section 13 provides for the repeal of section 17 of the Criminal Law (Amendment) Act, 1935. There are four subsections in that section. Subsection (1) made it unlawful for any person to sell or expose, offer, advertise or keep for sale or to import or attempt to import for sale, any contraceptive. That prohibition has effectively been replaced by the provision of section 4 and 5 of this Bill. Subsection (2) provided penalties for breach of the section; subsection (3) was declared unconstitutional by the Supreme Court in its judgment on the McGee case; and subsection (4) contained a definition of contraceptives.

Of the remaining sections of the Bill, section 14 provides substantial penalties for persons guilty of offences under the Act, penalties which are considerably heavier for second offences and for continuing offences than they are for first offences. Section 15 provides for situations in which offences under the Act are committed by incorporated or unincorporated bodies of persons and section 16 empowers the Minister to make regulations in relation to those matters in the Act where regulations are required to spell out detailed implementation of specific sections of the Bill. Section 17 contains the short title, provision for the citation of the Act with other Health Acts and for their construction, and provision for the Act to be brought into operation by order of the Minister.

I hope Deputies will accept that this Bill is the result of careful and earnest consideration of a difficult situation and that it is a sincere attempt to meet that situation in a reasonable and acceptable manner. There is very little support for a situation in which all forms of artificial contraceptives could be widely advertised and made freely available through a variety of sources to anyone seeking them. We must, on the other hand, following the Supreme Court decision in the McGee case, avoid a situation in which the conscientious and informed decision of parents in relation to their families was interfered with by legislation which denies them access to the modes of contraception which they have decided to adopt. It is not easy to devise legislation which satisfies both these criteria. The best method, I believe, is to provide a comprehensive family planning service and to limit the availability of artificial contraceptives to the purposes of such a service.

I recognise that this legislation will not satisfy everybody. There is no legislation which would. There are diametrically opposing views sincerely held on practically every aspect of this issue. There are powerful lobbies ranged on different sides. There are many people around who want to impose their views whatever others may think or whatever the consequences may be. There are commercial interests seeking their own ends. I think the time has now come when the parliamentary process should prevail. Everybody has had his say. It is now a matter for the elected representatives of the people to decide.

This legislation opens no flood-gates, but it seeks to meet the requirements of those who either have no objection to the use of artificial contraceptives or who, having found other methods unsatisfactory, wish to utilise means other than natural family planning methods. It invokes the co-operation of the medical profession whose involvement in the provision of family planning services is the best guarantee of their availability and their successful implementation.

It provides that who find the provisions unacceptable need not involve themselves in any way. This Bill seeks to provide an Irish solution to an Irish problem. I have not regarded it as necessary that we should conform to the position obtaining in any other country.

I commend the Bill to Deputies on the basis that it will be found acceptable by and meet the wishes of the great majority of sensible responsible citizens.

Mr. Boland

May I start by acknowledging the fact, as the Minister said, that this is a difficult situation and represents a considerable task for any Minister charged with introducing amending legislation. This legislation does not open any floodgates but it is well at the outset that I should examine the situation that exists and has existed since the Supreme Court decision now a little over five years old which, in my belief, had the effect of partially opening the floodgates. Since that time especially it has been obvious to anybody who examined this area that there is a need for amending legislation, that the situation which obtained consequent on the court's ruling was unsatisfactory, and it has been a duty on the Oireachtas to mend that situation. That point of view seems to be so obvious that I do not understand why people even with completely different outlooks and aspirations in the area of family planning and contraception cannot agree that there is a need for legislation of some kind to mend the situation which arose as a result of the court's ruling and which the court seemed to urge in the ruling they handed down that the Oireachtas should attend to as soon as possible.

Some of us felt, even before the verdict of the court, that there was a need for the Oireachtas to examine this entire area as it was controlled by the 1935 Act. In that respect perhaps we might have hoped for different legislation from legislation merely to mend the situation that arose as a result of the McGee case. In either event, some form of legislation has been necessary, particularly over the past five years. The situation the Minister outlined is quite correct. Any person of any age, as long as he or she had sufficient money and the ability to communicate, could arrange to import contraceptives to an unlimited degree in a completely uncontrolled and unrestricted way. I do not think any of us from any viewpoint could have felt that that was a satisfactory situation.

As a by-product of the ruling on the McGee case the section prohibiting the sale of contraceptives can only be described as being of dubious constitutionality. It was apparent that, if a test case were taken in relation to that subsection, it was highly likely that the courts might have found as they did in relation to section 17 (3). That being the case, it is particularly unfortunate that the Oireachtas have not managed in the five years since that court ruling to have taken what I would have considered to be the relatively simple step of repairing the law and restoring some sanity to the situation and in the process acknowledging the de facto position which exists and endeavouring to provide some form of realistic legislation to provide for it.

There is no gainsaying the fact that the everyday decisions of many thousands of Irish men and women have meant that the legislature has been passed by in this important area. The question we must ask ourselves now, and should have been asking ourselves for the past number of years, is whether we are prepared to continue in this ostrich-like approach by the Oireachtas on matters such as this.

As I pointed out in relation to other debates, we are the country with the youngest population in Europe. We are the single State within the European Community, perhaps throughout the western world, where democracy is going to stand the stiffest test that any democratic system has ever been put to over the next one or two decades because of the peculiar make-up of our society. It still appears highly likely that many aspirations, especially job aspirations of our young people, may not be capable of being fulfilled.

We have a parliamentary system that is essentially slow, cumbersome and Victorian in its make-up and outlook and the manner in which it reacts to changes in society or to the issues of the day. I wonder for how much longer we can afford to indulge in the charade of assuming that family planning or the use of contraception or contraceptives is not widely practised here. If we wish to engage in that sort of luxury within the confines of parliament, I am afraid it can only be at the expense of a continuing loss of respect for the effectiveness of this parliament, a loss compounded by many of the other shortcomings we realise exist within the parliamentary system, and a loss of respect which will be identified in the area where it is most to be regretted and feared, that is among the young people.

As I said, I believe that all that would be needed following the McGee judgment was a relatively simple and overdue updating of legislation. The fact is that that has not taken place. For five or six years prior to that judgement there had been a continuing debate on this matter, more especially in the other House. It is regrettable that it should have gone on for so long and that we are today discussing more legislation in this area. I did not believe it necessary that this issue should have, to a large extent, occupied the centre scene of the Irish political stage over the last ten years. It has done nothing to raise the stock of the legislature in the minds of the people nor the image of this country in the eyes of the world.

I should like to place on record my own personal point of view. Next summer I will be ten years a member of the Oireachtas, and eight of those years were spent in the other House. On several occasions there I took the opportunity of speaking on various measures to amend the 1935 Act and consistently outlined my view which was that there was a need for parliament to recognise the situation as it existed and the rights of people to order their sexual affairs in private as they saw fit. I still believe that. It is a little sad that, at the end of ten years and having contributed to that debate at various times, I have to confess that to some extent I have grown weary of the entire debate and I think the nation has grown weary of it, too. We in parliament, despite repeated debates and expressions of good will, good intent and anxiety on the part of almost everybody to appreciate and understand the genuinely held viewpoint of others, still have not been able to enact legislation that is workable and recognises the situation.

It is time this Parliament endeavoured to catch up with the de facto situation in relation to family planning. However, I must ask if this Bill as drafted is the only method whereby parliament can mend its hand. Is this to be the sole vehicle whereby some sanity can be restored to the debate? Is this the only possible modus operandi to take from the political arena this matter which is essentially of a private nature?

In relation to legislation generally there is no doubt that moral standards as such do not change. We often read and hear different people claim that the moral standards of the nation are changing. I do not believe that, in general, the moral standards of the people change. It is the limits of tolerance that change, the amount society is prepared to tolerate in relation to either public or private morality. Basic moral standards do not change. I accept that it would be quite wrong for a parliament to react in an over-hasty sort of way in response to those changes in the degree of tolerance. They may often move back in the opposite direction. Even accepting that parliament is correctly cautious because over the years many pieces of legislation have stood the test of time I do not think that any of us in this parliament could make the excuse that the continuance of the 1935 Act until one subsection of it was overthrown by the courts was an awaiting by Parliament for the shifts of tolerance to restore some degree of credibility to that Act.

The last time I spoke in the Seanad I said in relation to legislation in volume 86, column 127 on 9 February 1977:

. . . the question has been raised as to what legislation is or what legislation should do. I do not believe that many members of the Oireachtas expect legislation to force an individual to be a better person. None of us can force anyone else to be a better person against his will. Neither can legislation force anyone to be a better person against his will. All legislation can do is impose limits, impose a set of checks and balances, set certain standards of public morality and protect the individual against the excesses of others, guarantee certain rights for them. Legislation cannot make him a better man. It might be able to prevent him from committing certain acts for fear of the penalties and punishment. Legislation might not make him a worse fellow but I do not believe it can make him a better fellow. It cannot guarantee that he will observe the rules of his church or whatever church happens to be the majority church at the time. It certainly cannot dictate in regard to his private morality. That point has been clearly demonstrated by the decision of the Supreme Court on the constitutional case which is fundamental to the whole argument. . . .

I still believe that. I read recently an extract from a lecture given by a very famous justice, Lord Devlin, on morals in the criminal law. This particular paragraph is very relevant to this debate and relevant to what I just quoted from my last speech in the Seanad. He said:

The last and the biggest thing to be remembered is that the law is concerned with the minimum and not with the maximum; there is much more in the sermon on the mount that would be out of place in the Ten Commandments.

That is particularly relevant to legislation generally, certainly legislation which endeavours to provide controls in the area between public and private morality. There is far more in the sermon on the mount than could be provided for in the Ten Commandments. Lord Devlin further said:

We all recognise the gap between the moral law and the law of the land. No man is worth much who regulates his conduct with the sole object of escaping punishment, and every worthy society sets for its members standards which are above those of the law. We recognise the existence of such higher standards when we use expressions such as "moral obligation" and "morally bound". The distinction was well put in the judgement of African elders in a family dispute: "We have power to make you divide your crops, for this is our law, and we will see this is done. But we have not power to make you behave like an upright man".

I came to my conclusion in 1977 but I was very pleased to see how much it was in line with the words of the learned justice. No law can make somebody an upright man and no law in relation to matters of private conscience and private morality can make him a better man. He must decide that for himself. It is something which parliament should respect, that he has the right to decide for himself as to how good or how bad a person he wants to be. The law can say what he may not do and impose certain punishments to protect society in general and the public order.

Laws generally should be limited to the regulation of aspects of conduct which are predominantly social rather than predominantly private. We are in a peculiarly Irish situation when we have so many people who agonise with their conscience so much on this particular matter and yet not on other matters of human justice or basic social justice. It is a peculiarly Irish thing that we seem to have a conscience only when it comes to sexual matters but we do not have any qualms of conscience about coming in to make decisions or walk through lobbies in relation to equally important matters of social justice, rights of an individual and the manner in which we treat the less well off sections of our society. When it comes to matters relating to sexual conscience we all challenge the theologians who advise the Vatican and the other major churches. This is probably part of the reason why this debate has dragged on for so long without being a credit to any person.

My approach in this matter is in relation to the area of family planning and contraception and the right which I believe belongs to an individual to decide for himself or herself how he or she orders his or her sexual affairs in private without interfering with anybody else. It is unfair that those violently opposed to any change insist on continuing to link the debate on this matter with divorce, abortion, euthanasia, sterilisation and all the other words designed to cloud the issue and to suggest to anyone who feels he wants to bring about a reasonable change, a recognition of the de facto situation and the genuine aspirations of many young Irish men and women, that they are opening the floodgates to promiscuity and the permissive society. Everybody who speaks in this debate should say very clearly that we are talking about reform of the law in relation to family planning and contraception. That is the only matter which is before us. Any of the other matters which have extraneously been dragged into the debate by certain people for the promotion of their own points of view are outside this debate, outside this Chamber and outside the decision which this political party and I believe any other political party in the House might make in relation to any of those other matters if they arise. We will deal with them when they come up but they are not a matter of concern at present. They are not part of this debate and should not be used to bully or coerce any individual or group of individuals in the House into voting one way or another.

I have taken some trouble to set out honestly my viewpoint on this matter. I accept that it is a viewpoint which will differ from that of others in this House and in the Seanad. I sincerely respect the point of view of people who feel that they cannot in conscience bring themselves to support any change in legislation and who feel that any change can only bring about a worsening of the situation. I do not agree with them, but I respect their right to hold that point of view. All I ask from them in return is that they allow me to hold my point of view and respect the fact that I have genuinely come to these conclusions.

I want to set out the position in regard to my party. We have for some years at several Ard-Fheiseanna committed ourselves to the introduction and implementation of a realistic policy in relation to family planning. That was reiterated again at our Ard-Fheis last May. I spoke extensively on this matter and the delegates reiterated the previous commitment by the party. The Ard-Fheis is the single and most important decision-making body on policy. We have traditionally held the view that on matters such as this which relate to a person's conscience and private belief we should not seek to impose on any member of the parliamentary party or any member of the party at any other level the majority decision of the party in the manner in which they vote. I think that is a very good thing. It is in many ways a reflection on the Irish parliamentary system and the way it evolved that there has not been a greater tradition in allowing members of political parties to vote as they see fit on matters which they believe to be of great import to their conscience.

As I have said in the Seanad and other places, my belief is that the area of distinction between private and public morality should be the subject of a free vote at any time, that it should be referred to an all-party grouping and consensus legislation should be put forward. That would better reflect the general overall view of the people with their differing views, attitudes and philosophies. Part of the difficulty in relation to this debate has been the imposition by different parties of whips to vote in particular ways. I would have thought that the Irish parliamentary system, Irish politics and democracy in general would have been better served if all the parties allowed their members to vote as their consciences dictated. I do not think there would be any loss in electoral reputations in doing that. More credit and respect would be gained by Parliament if that were done.

I hope the Minister realises I am not saying this in any political way, but I do not believe that each of the 83 other Deputies in the Minister's party is in complete and enthusiastic agreement with the measures in this Bill. If that party represent a broad cross-section—which they obviously do since they won so many seats—surely some of those Deputies feel, as do some members of my own party, that they do not want to support any measure in this area. Surely there are other Deputies who are disappointed that the Minister did not feel in a position to introduce a wider and more liberal measure. Is it not rather difficult to believe that each of those 84 Deputies from different social backgrounds, financial circumstances and philosophies and representing all parts of the country, has decided to agree totally to the measure?

I found it impossible to believe that each and every member of the Labour Party in 1974 had decided totally and absolutely in favour of the measure of the Government of the day. It would have had more effect on the attitude of the people in 1974 and would have more effect now if all Members of the Dáil were allowed to vote as they saw fit on matters which do not impinge on the running of the State but rather relate to the individual and how that individual lives his life and conducts his private relationships in private with other human beings. There are differing viewpoints within our parliamentary group, just as there were differing viewpoints among the judges who handed down the decision in the McGee case in the Supreme Court and brought about the final realisation that there was some need for amending legislation. It is good that there should be those differences, that society has the checks and balances of having people with differing viewpoints and philosophies.

I have never been able to understand and have been saddened by the vehement and occasionally vitriolic criticism which has been levelled, mainly at my party colleagues but also at others, because of the manner in which they voted on measures such as this in the past and very often because they voted in the opposite lobby to me. I did not feel any annoyance with them for doing so. Surely it is the most illogical of sentiments for someone to castigate a person, especially a parliamentarian who is in public life, for voting as his personal beliefs demand, simply because that vote happens to be at variance with how the critic looks at the same issue. Some of the most outspoken critics on these occasions are the people who would indignantly insist that they themselves are the most liberal of fellows. I cannot see that any person has an ounce of real liberalism if he is not prepared to respect the vote and the viewpoint of somebody else, especially in an area such as this.

I believe the State should not interfere in the sphere of private morality, of conscience and of personal choice, as long as those areas do not injure the common good, public order or morality. In common with every other legislator and every other responsible or concerned citizen, I share the anxiety that the moral fibre and values of our society should not be eroded. I am as anxious as any parent that my children should grow up in a healthy and Christian society. In that regard I would not be prepared to yield best to any man; yet I and others like me will be criticised because we say there is a need for change in legislation on this matter.

We cannot close our eyes to what is happening around us. We cannot ignore the legitimate demands of many young couples that they be allowed to plan their lives and their families in the manner best suited to their personal needs; nor can we afford to deny their claim that they be allowed to order their sexual affairs as they see fit and as a matter between themselves and their God. In so far as it does not interfere with the good order and discipline of the State, I do not see how their call can be denied, and neither, if I read the judgment correctly do the courts of the land.

I have gone to some trouble to outline my own and the party's attitude in this area. We awaited, with a great deal of interest, the publication of this Bill. The Minister, on foot of an election promise, set up an all-party informal committee. It would have been appropriate if that committee had been asked to give their views to the Minister as to how best this legislation might have been produced. In the event, that did not happen and the committee only met once since their inception. The Minister promised Deputy Quinn some six or seven months ago that before he published this Bill he would have consultations with the Labour and Fine Gael Parties. I do not know if there were consultations with the Labour Party or with Deputy O'Connell but there were certainly no consultations with this party. From that point of view, this is the first opportunity I have had of outlining my reservations about the Bill.

When the law is made to look a farce it is time for it to be amended. When the amending legislation to correct that situation is in itself in many repects a farce ab initio, one can only wonder at the system that produced it and at the political will of the promoter of the legislation. I am disappointed at some of the provisions and the basic thinking embodied in the Bill. It says very little for the Government's social conscience or their awareness of the issues involved when it handles such a sensitive matter, which causes so much marital and personal stress, in this way. Admittedly, it is a cleverly worded attempt which appears designed to rid themselves of a problem rather than helping to solve the real problem facing many thousands of young, caring and concerned men and women.

There are three main areas in relation to the Bill that cause us considerable concern. The first is—the Minister acknowledged this in his speech—that central to the McGee judgement was the fact that the 1935 Act was repugnant to the Constitution because it invaded the privacy of Mr. and Mrs. McGee and did not allow them to order their sexual affairs as they wished. The courts, very correctly, pointed out the constitutional right of these people to make up their own minds in private as to how they should order their sexual and family affairs. The Minister said that the Supreme Court also has indicated that families, in arriving at decisions about the methods by which they plan their families, should not have those decisions impeded by the action of the State.

The Bill hinges on the idea that people, in order to get advice on family planning and to get the various forms of contraception, will have to go to a doctor and obtain from him a prescription or authorisation, even if the contraceptive they want to get is of a non-medical nature. The Bill recognises that they are of a non-medical nature because it sets out in section 4 (2) that the person is seeking the contraceptive bona fide for family planning purposes or for adequate medical reasons. The medical reason is the alternative not the primary reason for visiting the doctor. The primary reason is for family planning purposes.

The right of a husband and wife to decide how to order their sexual affairs is apparently, under section 4 to be discussed and decided upon by a doctor, not in his medical capacity, not with his training qualifications or expertise in healing the sick but because he happens to be there and is a device that can be used to implement the measure. He writes the script for family planning purposes or alternatively for medical purposes.

The section also provides that the prescription or authorisation must contain reference to the fact that it has been written in accordance with this Bill. Not only is the doctor to be taken into consultation with the Mr. and Mrs. McGees of this world as to how they order their affairs but notification is to be given to the pharmacy that the items on the script are being dispensed for family planning purposes. It is of great concern to us that the very kernel of the McGee judgment appears to have been violated and breached in this Bill. It appears highly likely that the provisions of this Bill will be challenged and the joining of the doctor and, to a lesser degree, the pharmacist into the private decision of the couple would not be regarded in a benign fashion by the Supreme Court.

The Bill hinges around the medical profession deciding who should and should not be eligible for the prescription of contraceptives. The Minister has placed the House in the invidious and intolerable position of having been used as a propaganda vehicle to endeavour to influence the medical profession at a meeting which they will have tomorrow. The Central Council of the Irish Medical Association met last January and decided they would not recommend to their members that they should participate in the implementation of the Bill. The Minister met a deputation from that organisation and, as a result of that, they agreed to reconsider their decision at their March meeting. Their March meeting takes place tomorrow morning. To our surprise, the Minister suddenly insisted that this Bill, which has been in existence since before Christmas, must be discussed today. I could not at first understand why. I have to confess now that I believe it was an effort through this debate to bring pressure to bear on the medical profession to persuade them to change their minds. This is the second real area of concern to us, that there has been an abrogation of the Minister's responsibility. It is not a nice responsibility or one that I envy him but there is a responsibility on the Minister to decide who is, who should or should not be eligible for family planning services and the availability of contraceptives. The Minister has abrogated that responsibility. The decision should have been taken by him and placed firmly in the legislation but, from his desk in the Custom House, he has assigned that responsibility to the waiting rooms and surgeries of doctors, especially general practitioners, throughout the country. That was not a fair thing to do.

It is not fair to try to place on doctors the moral responsibility for deciding upon eligibility generally for contraceptives. It was a cynical piece of buck passing. In what way does a doctor's ordinary medical training qualify him to pass judgement on whether the person visiting him is, to quote from the Bill, "seeking the contraceptive, bona fide, for family planning purposes and in appropriate circumstances”. This is what the legislation will require the doctor to do, in effect, to sit in moral judgement on the people of the nation. This is not right and the majority of doctors do not wish such a burden to be placed on their shoulders. It will be left to the doctors to decide on what is or is not a family. It will be left to the doctor to decide that a married woman who had her last child 18 months or two years ago is not now seeking contraceptives for bona fide family planning purposes. Will he have to decide that the common law husband and wife are not bona fide people who have a real interest and concern in family planning matters?

If this Bill is implemented as it is set out now, will not the opinions, judgements and decisions vary according to the personal beliefs, or in certain cases the lack of personal beliefs, of some of the doctors? Will applicants have to go to a doctor's surgery to explain their own religious and personal beliefs, their philosophy, their outlook, their family and financial circumstances and the many other factors that influence couples in deciding that they want to avail of family planning? Will they have to explain all those factors to an overworked, busy GP before he decides on a non-medical matter in which he has had no training or education? It is an odious responsibility to place on a general practitioner, the decision as to who should or should not be allowed to purchase condoms.

I wonder how many doctors now practising realised when they undertook their six years or more of training, followed by subsequent experience and the expertise gained in treating the sick, that all of that was a preparation to now being placed in a position when they will by law be allowed to write chits for condoms? Was it for this that they and their families and the taxpapers contributed so much in time and money during the years? Let us be honest about this. The decision as to who should or should not be allowed to purchase a condom has as little to do with the general practitioner as chiropody has to do with a dentist.

I am surprised that the legislation relies so heavily on doctors as the main people for decision-making. In the debate in 1974 virtually every Deputy who spoke from the Minister's party who were then in Opposition suggested that the most logical method of having contraceptives distributed and family planning services provided was through the health boards. In fact, Deputy Hugh Gibbons, who is not a Member of the House now, indicated that in certain cases he considered doctors were not the appropriate people to be involved and he indicated he was in favour of the health boards being the responsible people to provide this service. Deputy David Andrews was the one Fianna Fáil speaker I came across who suggested a scheme that would appear to have been the forerunner in thought to this Bill, but every other Fianna Fáil speaker advocated that the health boards should carry out the family planning services. I find it rather ironic that under the terms of this Bill the health boards will be obliged to set up advice centres in relation to family planning matters but they will not be allowed to dispense contraceptives.

We are in a situation where the odious responsibility of deciding on non-medical matters is placed on a doctor. We are forcing people in full health to visit a doctor's surgery. For the last few months we have been urging people to cut down on their visits to the doctor. We have been pointing out that the average person pays an unnecessary number of visits to the doctor each year. Recently the Minister launched a campaign to discourage people from thinking that they should be given a prescription every time they go to a doctor and to discourage people from expecting that they must have something dispensed from a chemist. In that context we were talking about people who were sick but now the Minister wants to send healthy people to a doctor, to get a prescription and to go to a chemist to have something dispensed. That seems at variance with the entire concept of discouraging people from overworking doctors, from having an over-reliance on drugs and an over-anxiety to obtain prescriptions every time they visit a doctor.

We are placing the doctor in a semior quasi-judicial role because in section 4 (2) it is stated that once the doctor writes the prescription it shall be conclusively presumed that the person has been given the prescription for bona fide family planning purposes. Not only is the doctor to be the arbiter, the moral policeman of the nation, but he is being placed in a role where his decision put on an authorisation, not on the basis of medical knowledge, expertise or training, is to be the conclusive proof which will leave the subsequent people who have to deal with the prescription and the holder immune from any recourse of the law. In other words, once a doctor signs a prescription and hands it to a person, whether he was right or wrong that person has immunity from the law and from any of the so-called penalties set out in this Bill.

There is a particular personal and practical difficulty presented to any doctor now who thinks he might want to opt out of this situation. The Minister has said that he has a conscientious right to do this but I should like to point out that although there is a marginal note referring to conscientious objections the section itself makes no reference to objections of conscience whatever. It allows a person the right to opt out for any reason he or she wishes, whether it be conscience or otherwise. If a doctor opts out of this scheme his patients will find themselves in an embarassing position. They will hardly leave the doctor to whom they and their families go for all other health services, to visit a different practitioner simply for the purpose of having an authorisation chit for the purchase of condoms. Therefore, a doctor who for reasons of conscience objects to the principles enshrined in the Bill and decides not to work it will find that a number of his patients will leave him because they will not want to put themselves in the embarrassing position of having to go to one doctor for all family medical services and to another doctor simply to get the benefits of this Act.

That represents a particular difficulty that exists in rural areas where there is a scarcity of doctors, where often there may be only one doctor. If that doctor opts out of the scheme, to whom will the person affected go? The provision also seems clearly to place an additional cost on people in Ireland more than anywhere else who wish to avail of contraceptives. They will be obliged to pay medical fees and pharmacist dispensing fees. That does not appear to me to be fair. That is the second of the three areas of real concern we have on this side.

The third area is one with which, to my amazement, the Minister has not dealt. It is a problem that must be causing extreme concern to every doctor who is now being invited to write authorisations in relation to non-medical matters in regard to which, as I have said, he has not got any training or expertise. The problem relates to the application of the Consumer Information Act, 1978. Section 6 of the Act is somewhat different from the corresponding section in the British equivalent. It provides for the imposition of penalties on people who make false or misleading statements as to services and so forth, and it lays down that if a person, in the course or for the purpose of a "trade, business or profession," does certain things—the British equivalent provision excludes "profession".

That section in the Irish Act states that if such a person recklessly makes a statement—I am quoting from different parts of the section—in relation to the provision, in the course of trade, business or profession, of any service, or the fitness for purpose of any service, or as in subsection (4), the examination, approval, use or evaluation by any person of any service, that person shall be guilty of an offence. Subsection (2) states that for the purpose of this section, anything likely to be taken for such a statement as to any of those matters shall be deemed to be a false statement. Paragraph (b) of the subsection provides that a statement made regardless of whether it is true or false shall be deemed to be made recklessly unless the person making it had adequate reason for believing it was true. The most frightening thing of all for a GP faced with the prospect of writing chits for a non-medical purpose is subsection (3), which provides that in relation to any services consisting of or including the application of any treatment or process, this section shall be taken to include the effect of the treatment.

Is a general practitioner to be invited, when somebody comes to him to discuss contraceptives, to write a chit or prescription for non-medical contraceptives specified in the Bill as being non-medical? It has been accepted in the legislation that that doctor has not had training or special education, that he has as much expert knowledge on the matter as the patient coming to him. Is he to be placed in a situation where, if the item which he has prescribed or authorised does not have the desired contraceptive effect, the patient would be entitled to claim that the treatment or the service provided had not been satisfactory and that the doctor was in violation of the Consumer Protection Act? Would such a doctor also be left open to civil damages? The Act contains criminal penalties of £500 or six months' imprisonment for a first offence and £10,000 or two years' imprisonment for a second offence, plus a rather difficult onus of proof placed on the defendant.

Where would the doctor stand from the point of view of civil liability if any of these non-medical items which he had prescribed were not effective and a pregnancy resulted or some other effect that had not been intended? I am amazed the Minister did not see fit to enter a saver clause in section 4, or if he did not think that was necessary, he should have dealt at some length with this real fear by doctors that by having prescribed something they knew nothing about they would be in violation of the Consumer Information Act and therefore liable to civil as well as criminal damages.

There are some other items which I propose to deal with briefly. We agree with the Minister's reiteration of the prohibition of abortion or of anything to do with it. There is reference, however, to abortifacients, but extraordinarily there is no attempt whatsoever throughout the Bill at a definition of what an abortifacient may be, although we all know of the considerable debate and controversy at present in relation to the abortifacient effect of some items used for contraceptive purposes, mainly IUDs. I will not bore the House or embarrass the Minister by quoting from a speech by Deputy O'Malley in 1974 when he complained about the inadequate definition of abortifacients in the 1974 Bill.

On this occasion, for some reason or another the Minister for Health has got over that by not attempting to define abortifacients at all. Now, everybody involved—the pharmaceutical chemists, the wholesalers, the importers, and especially the doctors—have been left in a position where it will be an offence to have anything to do with abortifacients, but the legislation does not attempt to define what an abortifacient is. I am not saying that the definition in the 1974 Bill was a very good one but it contained an important provision which has not been repeated in any shape or form in this Bill. Section 7 of that Bill provided that the Minister might appoint a committee to advise him on whether a particular preparation or appliance was an abortifacient and whether such a drug, preparation or appliance was also a contraceptive. The section provided that the committee would consist of not more than five persons among whom would be persons with medical qualifications. Licences would not have been granted, according to that section, in respect of a contraceptive which in the opinion of the committee was also an abortifacient.

At least that made some effort to define an abortifacient for the medical, pharmaceutical and other professions involved. Now doctors and others are left in a position where certain items in common use which are widely suspected of being abortifacient in their effects may or may not be prescribed and may leave those concerned open to criminal proceedings if they prescribe them. It is a very sensitive, delicate and tricky field but they are not to be given any assistance by the Bill.

The situation in regard to family planning clinics will be changed dramatically. Health boards will be obliged to set up information clinics to give information to people on different methods of contraception, natural and artificial. The Bill also provides that other people will be entitled to apply for licences, these people presumably being those who are running family planning clinics now. I agree entirely with the Minister that existing clinics should apply for licences. There is no gainsaying that during a particularly difficult period, when the Oireachtas was negligent in its duty, a number of these clinics fulfilled an important function in helping young families. That should be recognised.

Under this new provision none of these clinics will be allowed to distribute contraceptives. That provision is too farreaching in its effects. There is the restriction that none of these clinics may be operated without a licence from the Minister and the Minister would have the necessary control to ensure that a clinic was operating properly. If he were so satisfied, then, in the issuing of his licence he could allow a clinic in certain circumstances to issue contraceptives. In certain cases where a clinic could dispense advice but was not licensed to issue contraceptives persons attending at the clinic would be placed in a difficult position. It is extraordinary that the statutory health boards should be allowed to set up clinics and not then be allowed to distribute contraceptives in conjunction with advice. The Minister has said that the health boards have indicated that they did not want to be in that situation. I wonder how workable or attractive a health board information centre will be if a person, having been advised at the clinic that X, Y or Z appears to be the most appropriate thing for him, or her, is told to go to the GP to get a chit to be dispensed by a chemist, as soon as the door is open to operation of the scheme. That is a particularly cumbersome method of working. I would have thought that health boards who have statutory responsibility, could have been trusted to take part in the distribution of contraceptives as well as in the dissemination of advice.

Family planning clinics which have been properly checked out and are controlled to the satisfaction of the Minister could, before an issue of licences, be allowed to distribute contraceptives. I am sorry to have to say that of late I have begun to get complaints and indications from certain people that some of the clinics are going beyond the bounds that many of us would never have dreamed they would have reached or would have wanted them to go to. The fact that these reservations have been expressed may be one of the reasons why the clinics have been treated in this way within the legislation. This is worthy of consideration before this Bill is enacted, if it is enacted at all. If the Minister is in a position to issue licences he should be in a position to be satisfied that the clinic is being properly supervised and therefore ought to be allowed to distribute contraceptives.

I am surprised that the legislation does not contain a requirement for any of these clinics, either those outside the health boards or the health board clinics, that the personnel provided in them should be trained. I would have thought it extremely important to place on anybody operating one of these advice centres the onus of seeing that the persons giving the advice had been suitably trained. This applies especially in relation to the clinics which are to distribute information on natural methods of family planning. Anyone who has looked into this matter to any degree knows that advice on the ovulation or the Billings method if not carefully given in an exact and controlled way has little hope of being successful. Therefore, it is imperative that the staff disseminating that information be highly trained, and that the health boards also have an obligation to disseminate information on natural family planning methods. That that is not in the Bill is a defect. There is no reference whatever to an obligation being placed on the health boards or any other bodies providing these centres to have staff trained to a certain degree of skill and qualification.

There is a heavy reliance on ministerial regulation and we have had various examples over the last few months of how Ministers have used regulations to get around discussion in the House. Someone whom the Minister will know has objected consistently over the years to this parliamentary device to give the Minister power to write his own legislation after a Bill has been enacted. I do not like to see it contained in this Bill.

I find extraordinary the Minister's attempt to define family planning service—three words—by using two of those words, "family planning", in the definition section. If you want a definition of family planning service you must read the definition, which is not a definition at all, it is a contradiction or an absurdity. Section 1 says

"family planning service" means a service for the provision of information, instruction, advice or consultation in relation to any one or more of the following:

(a) family planning,

Is that a definition of "family planning service"? The Minister must be joking. One has to go to section 2 to read about the Minister's responsibility. The section says:

The Minister shall—

(a) secure the orderly organisation of family planning services, and

(b) provide a comprehensive natural family planning service,. . . .

Then the section goes on to define what a comprehensive natural family planning service is. Therefore, in the definition you substract a natural service to work out what is an artificial service. If you want a definition of the definition section you must read further down this Bill. That is either extraordinarily devious or extraordinarily inept and I do not think that the Minister is an inept man. Of course, it might have been embarrassing if the definition section had had to define what exactly is a family, because then the "all things to all men" aspect of the Bill, the representation to one side that it provides for all adult persons, the representation to the other side that it provides only for married persons, would be seen to be patently false. It could not be right on the two counts.

Of course, the Bill does provide for single persons. Section 5 provides that a person may import contraceptives into the State as part of his personal luggage when he is entering the State. No Interpretations Act and no court would assume that to be referring only to married couples. It is certainly not a definition of "family planning service". If the Bill is to have a proper definition section that needs attention. If there is to be a proper definition section some attempt should be made to define what is an abortifacient.

The drafting of the Bill is remarkable. It seem that under section 4 the person, after he has gone through this dreadful charade of finding a doctor who will write him a chit, must go to the chemist with that prescription. Section 4 (1) (b) (ii) provides that:

. . . the person to whom the contraceptives are sold is named in a prescription or authorisation in writing. . . .

I took legal advice on this. Could a man not send his wife, or could a wife not send her husband to the chemist? Presumably they would both be involved in the use of this contraceptive. The legal advice is no. Section 4 (1) (b) (i), referring to the chemist, says:

A person shall not sell contraceptives unless—

(a) . . . .

(b) he is, or is a servant or agent acting as such of, a pharmaceutical chemists,. . .

That wording is not repeated in section 4 (1) (b) (ii). The wife who might be a servant or agent of her husband, or the husband who might be a servant or agent of his wife, would appear to be excluded by the exclusion of the phrase which is in section 4 (1) (b) (i). Not only does one have to go through the demeaning process of going to the doctor to get a prescription for condoms but one cannot send the marriage partner to have the prescription dispensed. The person who obtained the prescription must attend in person at the chemist's shop.

I do not understand why the general practitioner is obliged to state on the prescription that the prescription is for the purpose of this Act. As I have said earlier, the Bill seems to be involving the pharmacist as well as the doctor in private decision-making in relation to the ordering of a couple's sexual affairs.

This section also appears to restrict absolutely the sale of these items to chemists. I wonder if the Minister has taken rural Ireland into account. In rural Ireland some dispensing doctors still exist; not only do they try to cure patients but they sell drugs and medicines direct to them, so it will be difficult to implement this Bill in rural Ireland. A dispensing doctor will not have the opportunity to opt in, because the sale can only be to chemists. A dispensing doctor carrying a range of other drugs that a pharmacy would normally carry would be precluded under this Bill from dispensing contraceptives. Poor rural people living in poor housing conditions and under financial constraints are the people who convinced me that there should be some sort of family planning available and these people are not catered for under this Bill. These people have very little opportunity to go to Dublin or to the main centres. One of the reasons in equity why there should be a realistic change in legislation was to allow these people the same opportunity that the wives of the people in this House would have of availing of these services if they wanted to.

There seems to be a lot of confusion about medical card holders. We all know that at the moment female medical card holders often have contraceptive pills prescribed for them but the doctors have to go through the farce of prescribing the pill as a cyclical menstrual regulator. I would have thought that under the provisions of this legislation at least that would have been dispensed with. Not only is it not dispensed with but now it can be argued that because the health boards have not been given that function and because they have been prohibited from dispensing contraceptives in their family planning clinics, they must question very closely any prescription issued to GMS card holders for items that appear to be contraceptive in their intent because health boards have been specifically excluded from the payment for or authorisation of such things in this Bill. That also is not designed to help the poor and less well off sections.

From the doctor's point of view, if he opts out for conscientious or other reasons, if he has a large number of GMS patients on his register it could be financially damaging. The GMS card holder, especially the male card holder, will now be told that the doctor to whom he goes for general medical services will not prescribe condoms so he will almost certainly approach the local health board to have his name transferred to another doctor. For their principles, doctors are likely to suffer financial damage. That is an unfair position in which to place a general practitioner.

There is an extraordinary situation in relation to sections 5 and 6. Section 5 relates to the control of importation of contraceptives and section 6 relates to control of manufacture of contraceptives. Section 5 says, in relation to the Minister issuing a licence:

. . . . grant to the person a licence authorising the importation of specified quantities of specified contraceptives if—

(i) the Minister is satisfied that the contraceptives are required by the person for sale to persons specified in section 4 (1) (b) (i) of this Act, or

In relation to the control of manufacture section 6 says:

. . . . if the Minister is satisfied that—

(i) the contraceptives will be sold to persons specified in section 4 (1) (b) (i) of this Act, or

(ii) the person is a person specified in the said section 4 (1) (b) (i)

But it does not say all the contraceptives nor does it say only to those chemists. As those sections now stand, as long as some of the imported contraceptives were sold to a chemist or some of the manufactured contraceptives were sold to a chemist there is no restriction on those people in distributing them to others. I would put that down to ineptness because I cannot see any other reason why that wording is here.

I agree with the concept in section 9, the making available of grants to organisations to carry out research into natural methods of family planning. At the Fine Gael Ard Fheis last May I said that an important part of the entire function of Government should be the encouragement of research into finding efficient natural family planning methods. At that time I praised the work being done in this area in Trinity College and in the Rotunda. We all have to recognise that while this is an extremely successful method in parts of the world, especially in the Third World, it has not achieved the same rate of success in Ireland for some extraordinary reason. That is all the more reason that we should inject money into research into this method. There is no need for this section here. This is a little bit of cream to sell the cake. The Minister is entitled to make grants available from his Estimates to whomever he wishes. If the Minister has a problem as to where to channel the funds, all the Minister has to do is to channel the funds through the Medico-Socio Research Board. As an expression of good intent, I do not disagree with this section but it would have been more honest not to have put it in at all because it is unnecessary. If it is necessary to have this section, why has the Minister excluded the provision of funds for research into the possible harmful methods of artificial contraception? Would it not have been appropriate for the Minister for Health to write some section into this legislation suggesting that money should be made available to carry out research into those harmful methods? That has not been dealt with at all. Yet, this is to be a comprehensive family planning Bill.

Section 11, described as dealing with conscientious objections, makes no reference to objections of conscience. It allows anybody to opt out for whatever reason he or she wishes. With all these reservations, the House must understand my difficulty. I took time and trouble to point out that I was very much in favour of a regularising, an improvement and a liberalising of the law to recognise the de facto situation that exists. When I look at the legislation that has been presented with its deviousness, its defects and the unfair responsibility which it places upon doctors in making them the moral policemen of the nation, the keepers of the national sexual conscience, it is very unfair. It is unfair to introduce constitutionally suspect clauses in relation to involving doctors and pharmacies in the sphere of private morality within a marriage, the very kernal of the McGee judgement, and it is extremely unfair to leave doctors open to the criminal action effects of the Consumer Information Act.

One of the reasons why this debate has gone on for so long is that we have always been a predominantly male-oriented Oireachtas. Many of the people who oppose change in this area might react differently if they were women. In my thinking in this area I have tried to understand the role of the woman who by God's design is the child bearing half in any sexual relationship. For 12 years I have been a member of a very big local authority. I have a lot of practical political experience, and experience of the social problems of couples in bad housing circumstances and of couples both of whom are working in an effort to build a house and create an environment in which to provide for their family, not because they are selfish as alleged but because we all recognise the high cost of marriage and of founding a family and a home and that they want to so order and space their family that they can provide in the most efficient way for their education and living costs as they come along. I have seen the fear and disappointment that ensues when that aspiration is not achieved when a pregnancy occurs unexpectedly. I have seen young mothers old before their time because of excessive pregnancies because of being obliged to rear a large number of children in poor financial circumstances in deadful housing conditions. I have seen all of these things that have convinced me that we as a Parliament should endeavour especially to think of the role of the woman in this regard.

It was all those things that convinced me many years ago that there was need for a compassionate change in legislation, a need to take our heads out of the sand and realise the decisions that have been taken by many thousands of young men and women who consider themselves no worse Catholics or Church of Ireland members or members of any other religion than other people. In that regard I think that the ordinary man or woman is very often in a better position to judge than many theologians because, with respect to the churches, as far as I can see there are as many views on contraception from theologians as there are methods of contraception. I know many thousands of Irish men and women are practising contraception and are regularly attending their religious services. I do not have a theological hangup about this—I suppose because I have a simple outlook on life—and when I found theologians with differing viewpoints in this area I decided to make up my mind as I saw fit.

I remember being told many years ago that a sin is not a sin until the person involved in the act himself believes it to be a sin. Quite obviously, many thousands of our population practise contraception and family planning and practise their religion. They do not believe they are committing sin; I do not believe they are. I do not believe that legislation that does not recognise that situation, that does not mend its hand and provide a realistic service for those people is bringing itself into disrepute and only causing and compounding further problems for itself.

I have great reservations about this legislation for the reasons I have outlined. I wonder what sort of situation will we be in, what sort of limbo we have been speaking in this morning, if the doctors at their meeting tomorrow reaffirm their decision not to work this legislation because the nub of the legislation is the odious responsibility placed on them. If they decide not to pick up that ball and run with it, are we in a situation where the Bill will be withdrawn or substantially amended? It is a ridiculous and untenable situation for me to find myself in. I can only say if this is the best that can emanate after all these years I am saddened. I can only hope that at some future date somebody will have more courage, more resolve and sufficient character to approach and finally settle the entire area of the State's role in deciding on the boundary line between public and private order and morality.

Dr. O'Connell

I come to this debate with a feeling of deja vu, that this cannot be really happening. In many ways I think contraception at this stage should be a dead issue. It is only here that we can solemnly discuss, not ways of helping people to live responsible and happy lives but actually a way of limiting their chances of so doing. After long years of discrimination in Northern Ireland when one-man-one-vote was finally granted there was a heartfelt cry of “too little, too late”. If ever the people of this island could echo that comment it is now with this Bill. In meeting the needs of Irish people on this issue, politicians—and I am not restricting my comments to one party—have failed miserably to respond responsibly and disinterestedly to the challenge of our times. I think it was Yeats who said, when an Abbey audience disrupted a play of O'Casey: “You have disgraced yourselves again”. That comment would equally validly apply to what is going on here today. It is ironic and a serious reflection on Irish people that in 1979 we should be debating an issue and trying to impose restrictive measures which did not exist in this country 50 years ago because contraceptives were then freely available with no outcry from either politician or priest. Nobody declared 50 years ago that a permissive society was rampant or that the free availability of contraceptives was leading to widespread abortion. Family life was sacred then even with the free availability of contraceptives.

Looking back on the 1935 Criminal Law Amendment Act, I found that the particular amendment was just put in as an incidental, that what we were concerned with had nothing to do with family planning. The Attorney General at the time said, and I quote him, that the Bill was "the result of the recognition by members of all Parties of the necessity for strengthening the law dealing with sexual offences, particularly with regard to offences against young girls. It has to be admitted that there has been an increase of offences against young girls in recent years in this country. This increase may be attributed, with a considerable show of reason, to the altered conditions of modern life, with its greatly enlarged opportunities for amusement and enjoyment, and the mingling of the sexes without that supervision which obtained in former days."

He further said:

It is, I think, generally admitted that the real cure for the ills which make this Bill necessary lies with parents and those charged with the care and upbringing of young persons. That such a measure should be introduced at all, should be, if such is necessary, a warning signal to all thinking persons and, in particular, to parents.

The main provision of that Bill was in respect of extending the age of consent for girls; it had nothing to do with family planning. Section 17 was only thrown in as an incidental and was not even discussed by the Minister who introduced that Bill. Here we are, 50 years later, making a feeble attempt to restore the fundamental rights of people to family planning and I think failing miserably in that attempt. Is it any wonder that we have become the laughing stock of the modern world? That is exactly what is happening.

I doubt if it is necessary to make it clear where I stand on this issue, or where my party stand, but for the record and to set the remainder of my remarks in context, let me do that now. I remember in 1970 I first tabled a parliamentary question asking the then Minister for Justice, Deputy O Moráin, if he would consider amending the Criminal Law (Amendment) Act. No one in the House knew what that Act was. The Minister said there were more urgent matters for consideration by his Department. I asked did he not think the right to contraception was an important matter, and the Fianna Fail benches created an uproar. They derided and ridiculed me and made me the laughing stock of the House. When I dared to mention the word "contraception" there was uproar in the House.

Senator Robinson, Senator Horgan and Senator West endeavoured in 1971 to highlight the problem and to introduce a Bill which would guarantee fundamental human rights which had been guaranteed by the United Nations Charter which was signed by Ireland. Their Bill was not even extended the courtesy of a First Reading. That is an indication of the closed-mind thinking of the Government. In 1972, together with Dr. Browne, I endeavoured to introduce a similar Bill in the Dail, but without success. We were ridiculed.

These efforts were not in vain because public attention was being focused on this important issue and women, in particular, were realising that their basic human rights were being trampled on. To digress, in 1970 I went down to Clare to speak to a group. There were middle-aged and elderly ladies there and when I talked to them about contraception, the need for it and the right to it, they did not rebel. They did not throw me out of the hall. They received me with courtesy and hospitality and we discussed it in a rational way. I was astonished, and I felt that as legislators we were failing in our duty in not explaining in a rational way the need for contraception as a basic human right.

It was obvious to me that a change in attitude was under way. The subject was beginning to be discussed. A debt of gratitude is owed to Senator Robinson for her persistent efforts in the face of mindless prejudice and obscurantism on the part of legislators. She succeeded in taking this whole matter out of the realm of of justice and putting it into the realm of health. A great deal of credit is due to that good lady for what she did.

It was only when the Government were forced to deal with the ramifications of the McGee case that in 1974 they finally agreed to bring in their own Bill dealing with contraception. I need hardly dwell on that fiasco, other than to say the position taken by some of our political leaders made a mockery of the whole legislative process. Five years later, here we are as a legislative body finding ourselves once more the object of ridicule in the eyes of the world with this pretence of a Family Planning Bill which makes our doctors the arbitrators of public morals. Once again we are refusing to recognise the fact that contraception is a basic human right declared as such in the United Nations Charter of which Ireland was a signatory.

My personal view is that access to contraceptive methods is a basic human right, no more, no less. This is a view which I have held and publicly stated since the sixties when it was not just unpopular but unthinkable in many cases to express such a view. This fundamental belief has been reinforced by my work as a doctor, my experience in this House, and my constituency work. My party and I take issue with this Bill in three main areas. First, it fails to take cognisance of the basic human rights of the individual. Secondly, it does not take as of prime importance the question of the dignity and the autonomy of women. Thirdly, it makes indirect obeisance to the Catholic Church view.

I will take first the question of the individual's rights. The rankest political novice could tell at a glance that this Bill was not drafted to meet the needs of the people. It is a piece of political fence-mending in the wake of the McGee case, not the greatest jumping off ground for any legislation. It does not even end there. The Bill is designed with a common denominator in mind, the lowest common denominator as represented by the backwoodsmen of the Fianna Fail cumainn. Often associated with the Minister's political style is the saying about politics being the art of the possible. It is a fairly cynical definition at best. When that definition is put to work as a guiding principle, as it evidently has been in the drafting of this Bill, that cynicism reduces all the possibilities to a singularly nasty compromise which is the best the backwoodsmen would allow through.

What kind of leadership is that? Of course politics calls for compromise, for working with groups of people who have different interests at times. I accept that. It does not and it should not call for this frantic pacifying of Fianna Fail grassroots supporters. This is a challenge of leadership. Can we listen to our people, learn from them and, at the same time, talk to them and carry them with us? If the traffic is all one way, if the backwoodsmen are winding us up and making our wheels turn, we are not in politics but in a sophisticated protection racket. That is what I see before me today. It reminds me of the old joke: "You can tell I am their leader because I am behind them." That is evident here.

There is a capacity within the Dail and even, I suspect, within the Fianna Fail Party to produce leadership on this issue. At the moment too many people are leading from behind the prejudices and fears of the unenlightened section of their supporters. That is a damning indictment of legislators in this House. Not only is the Bill a sop to backwoodsmen, but it is also the subject of much clever politicking to ensure that, if it fails, its failure will be seen to lie not with the Minister but with the medical profession, the doctors. No amount of pressure, no political blackmailing, no clever footwork will ever hide from doctors the fact that they are being asked to make moral judgments and bear the responsibility which would give credibility to the so-called politics of realism.

We should keep in the forefront of our minds that we should legislate for the future and not for the past. This Bill pretends to delve into the future, when its eye is fixed firmly on the rear-view mirror. It cribs, cabins and confines the lives of young people in order to massage the prejudices of the middle-aged and old. We have a huge proportion of younger people in our population. In conscience, can we offer them what they would call a Mickey Mouse compromise instead of what they need and want?

Not only have we a young population, but we also have a changing ethos. We hear a great deal of waffle about ours being a pluralist society. This is often taken to mean that we must not confine our thinking to the Catholic population but that we must think in wider terms because we have other religious beliefs. The fact is that pluralism has an even more interesting meaning. In Ireland we are pluralist in the sense that we have Protestants, Jews and many other believers. We also have non-believers. We are also pluralist in the sense that, within the community of believing and practising Catholics, there are differences of views, of emphasis, and of priority. All devout Catholics do not believe and practise along exactly similar lines. It is that variety which must inform our thinking.

Is it informing our thinking? It is true that Article 44 is no longer with us. Its passing was unlamented by many Catholics, including the late Cardinal Conway. He did not see that a special relationship between Church and State was necessary for the growth of either. Article 44 now seems to be re-appearing at the back door. We no longer have rule by the crosier because too many people like myself believe that the Church's role should not and need not be buttressed by the State's laws. As an alternative, will we have moral judgements by courtesy of the stethoscope? That is obvious to me in this Bill. If politicians find themselves unwilling or unable to separate in their minds their functions as law-makers and their responsibilities as believers, we may find ourselves in that very position.

Fundamentally it is the responsibility of politicians about which we are talking in this Bill. The Catholic Church in its statement of 4 April 1978 said that according to its teaching the use of artificial contraception was wrong, that this teaching was binding on the consciences of Catholics. But the Bishops' statement went on to say that it does not necessarily follow from this that the State is bound to prohibit the distribution and sale of contraceptives. There are many things which the Catholic Church holds to be morally wrong which it has never suggested should be prohibited by the State.

This is a clear, unequivocal statement from the Bishops that they have no intention of interfering in the legislative process. That is an admirable statement to make. But regrettably—despite this unequivocal statement that the Church will stand aside and permit our legislators to legislate for all our people—some members of the Catholic Hierarchy are already introducing a note of revisionism in that policy. They are aided and abetted by Catholic organisations in statements, loaded with emotive overtones and predicting dire consequences which will necessarily follow on such legislative change in this area—witness the leaflets being produced at the gates of this House, the linking of contraception with abortion. They say in clear, unequivocal terms: An abortion clinic in your area? The facts say "yes".

Mr. Haughey

From where did that leaflet emanate?

Dr. O'Connell

It was distributed at the gates.

An Leas-Cheann Comhairle

The Deputy should give us details of the leaflet, any title, who issued it and so on, just for the record.

Mr. D. Andrews

It is probably anonymous; they probably had not got the guts to put their names to it.

Dr. O'Connell

I have found it at last, in very small print—it is issued by the Family Life Centre, Knock Shrine, County Mayo.

An Leas-Cheann Comhairle

Is there a title?

Dr. O'Connell

It reads: Weep not for me. An abortion clinic in your area? The facts say "yes".

An Leas-Cheann Comhairle

The Deputy will understand that it is for the record only.

Mr. D. Andrews

The Deputy confused the issue. I thoroughly agree with his comments on this matter.

Dr. O'Connell

I want to make it clear, I would never object to and feel it is a sign of a healthy society that people should have the right to lobby. We should not deny anybody the right to lobby but distortion of facts is a very serious matter. As I see it, it is not lobbying; it is a subtle form of intimidation.

I have also another document handed to me as I came in the gates of this House: "No votes in June for you or your party if you vote for the Contraceptives Bill." That is not lobbying, as such.

Mr. D. Andrews

Blackmail.

Dr. O'Connell

Exactly, that is blackmail. I agree with Deputy Andrews.

An Leas-Cheann Comhairle

Again, for the record the Deputy might give us the people who issued that leaflet or its title.

Dr. O'Connell

The Irish Family League, 47 Dufferin Avenue, Dublin 8.

An Leas-Cheann Comhairle

Is there any title on it?

Dr. O'Connell

No, Sir, there is no title on it. The Minister, pandering to the dictates of these groups, is shirking his responsibility, deciding instead to throw the whole question over to the doctors. Irish doctors are not the arbiters of morals. They never have been and do not want to be, as has been made painfully obvious. Yet this Bill proposes to change their role radically, to put them in the position of making moral judgments about their patients—they must be satisfied, before authorising a prescription for contraceptives, that the person is seeking contraceptives bona fide for family planning purposes or for adequate medical reasons and in appropriate circumstances. I do not know what the Minister means by bona fide. He has not spelled out in his speech this morning what he means by bona fide for family planning purposes. Now we have entered the doctors' dilemma. How is a doctor to determine whether a person is seeking the contraceptives bona fide for family planning purposes? What rule or measure does the doctor use to judge appropriate circumstances? I will say merely that, in order to be constitutional, this provision must comply with the requirements of the McGee case.

As I read the judgment of Mr. Justice Walsh in particular—and indeed of others—it is far from clear that the rights recognised in that decision are as restricted as those provided by this Bill. There is nothing in the McGee case to indicate that married couples have the constitutional right of access to contraceptives only for bona fide family planning purposes or for adequate medical reasons. Indeed the whole tenor of that decision is to the effect that married couples have the right of access to contraceptives as they think proper, not for any specific purpose or purposes at all. If this is so, that section states that it cannot be constitutional. One can easily think of cases where married couples might wish to use contraceptives for a purpose other than family planning or of medical necessity. For example, they may wish to have no children. To describe the use of contraceptives as family planning in such cases would surely be an abuse of language.

I mention these points because I have not been enlightened by the Minister's speech this morning. He has not attempted to spell out what he means by bona fide for family planning purposes. If ever there was ambiguity written into a Bill, this is it. What does the Minister mean when he says that? Has the doctor to ensure that the person is married? These questions have not been answered. What about the widow or widower? What about the marriage that has broken down, though not legally? What about the thousands of annulments from the Catholic Church not recognised by the State? What about such cases that may confront the doctor? Is the doctor being asked to interpret the law, and what happens if he interprets it wrongly? Under this Bill he can be arraigned before the courts for authorising contraceptives to a person who is not seeking them bona fide for family planning purposes. It is not enough for the Minister to say that it is not the intention of this Bill to prosecute doctors for erring in their interpretation of its provisions. When the Bill becomes law the courts interpret the law, not the Minister's mind. Very few of my colleagues in the medical profession can restrain a shudder at the very idea of putting themselves in this sort of position vis-a-vis their patients.

Neither is it a simple situation. First of all there is the moral judgement facing the doctor: does he wish to authorise contraception to anybody? If he does not, then his patients must go elsewhere—with the consequent personal misery, inconvenience and injury of the special and important relationship between doctor and patient. Some patients may very well end up with a real family doctor and a contraceptive doctor which can only damage the credibility and lower the morale of the medical profession.

Let us assume for the moment that the doctor goes along with the Bill's basic premise, is prepared to authorise contraceptives to married people and to those with what we might call, stable sexual relationships. Here there is a basic infringement of privacy and dignity: dignity of the individual, infringement because we are saying: we will not treat you as an individual with individual rights but, because we have a family-orientated society, we will rate you as a family. If it is a married couple must both partners appear in the doctor's surgery to establish the fact that they are both seeking the contraceptives bona fide? What happens if one partner only appears? Must the doctor telephone the other spouse to confirm the request? This provision is in the Bill. If the Minister says “No”, what about a spouse who requires them for extramarital relationships? Is the doctor held accountable for the legitimacy of use? Responsible doctors have been searching around for some method of shaking off this responsibility, this degrading, unrighteous tinkering with other people's lives ever since the Bill was first mooted. How can it be done? If one tries to put the responsibility for contraception back where it belongs, with each individual, by leaving a padful of authorisations in one's waiting room for people to take when they come to one's surgery and fill in their names, they may fall into the hands of children.

Morally the thing just will not wash. Doctors are there to doctor and not to make moral judgments which they have not the slightest desire, not to mention the competence, to make. What is suggested here is that doctors are now the rearguard of the morality back-up. Peter Ustinov once said that the problem with most churches is that they start out by putting down sin and end up by putting down sinners. That is all very well if this is how a church operates, and I am not saying that that is so. But to make doctors into the instruments of putting down sin and putting down sinners is a distortion of what the medical profession is all about. So, morally, this Bill is not acceptable.

It has certain wider implications outside of strict morality which are worth looking at. One is the unspoken belief that adults in this country are not capable of making up their own minds or have no right to do so. This concerns me greatly especially as it affects women. The position of women in Ireland has changed for the better in recent years. This is largely because of the intervention of the EEC, which is prepared to drag its members, kicking and screaming, into the latter half of the 20th century in this respect at least. But it now appears that the rights of women and the enormous potential of women are to be sacrificed to this atavistic prejudice which is almost unspeakable in its quiet, purposeful brutality. At the back of the failure of many attempts to create humane contraceptive legislation is the unspoken belief that our women are most manageable when they are, if not barefoot and pregnant, then at least pregnant and surrounded by children.

There is more than the dignity of women at stake here. The role and the function of doctors are at stake. Doctors are not human dispensing machines for condoms and must not be regarded as such. If this Bill is passed, it will make them so. Doctors are already grossly overworked so why should we absorb much of their time in a needless rubber stamping exercise.

It is interesting that this Bill should come now at a time when the Department of Health, through the various health campaigns of the Health Education Bureau, are trying to convince people that the responsibility for their own health is in their own hands. People are being encouraged to see health as a resource that they must look after and not to see the doctor as a constant support and a fixture in their lives. It is a weird contradiction that this Bill should at this time take the responsibility for an area of their own health out of the hands of the individual and place it squarely in the unwilling and overworked hands of the GP. When I talk about taking responsibility out of the hands of the general public it is not just the narrow aspect of the question of contraception that I am talking about. People who cannot be responsible for their own methods of family planning are robbed of responsibility for their own physical health, if they are women, and also of responsibility for their mental health if they already have a family or are under pressure. Most ironic of all is the fact that for many of the people looking for contraceptives a visit to the doctor will be a new thing. They will come from the youngest and healthiest sector of our community. We are needlessly turning them into patients, turning them into health consumers, turning them into dependants. That is what will be achieved by this Bill. It is a total contradiction of the admirable stance of the Department and the Health Education Bureau in the matter of individual responsibility for health.

Let me touch now on the link which is being carefully forged in the public mind by those who do not wish us to create humane and proper contraceptive legislation. That link is summed up in the nasty dual phrase, contraception and abortion. They fit together very neatly because they have been shaped and polished and honed to fit into each other by those who do not wish us to think or talk about contraception on the basis that if we are scared of abortion then we can be scared off contraception. I wish to make it clear that I am totally opposed to abortion. That is why I think this is a nasty and irresponsible trick to play. It is nasty because, if there is a connection between the two, it is that freely available contraception should limit the demand for abortion. A total of 2,533 Irish women went for abortions last year. Hundreds have already gone this year. Even that 2,533 is but the tip of the iceberg, because that figure reflects only the people who went to England and gave Irish addresses, whereas many hundreds who go abroad for abortions do not give Irish addresses for fear that they might be identified. Already this year hundreds have gone to England to terminate pregnancies which might have been prevented by proper contraceptive methods. These ghastly statistics should give pause to those who trivially link the two.

Linking contraception and abortion is irresponsible and unproductive in the long term. It is a re-enactment of the story of the little boy who cried "Wolf" so often that he wore down people's sensitivity to the whole wolf problem and when the real wolf came they did not even get out of bed in response to his yells. If one yells abortion long enough when what is under discussion is responsible contraceptive legislation, then not only does one damage the chances of the creation of such legislation, but one desensitises everybody to the question of abortion. I hope those people who loath abortion so much will think again on this question. Shouting abortion when nobody is threatening it may mean that, when there is a real possibility, all of the forces that could be mobilised to oppose it will be just too bored and tired of the whole thing to come out and do something about it.

I must confess that this whole issue of abortion fills me with anger at the hypocrisy of our so-called Christian society. Last year 2,533 abortions were performed on Irish women. As a doctor I have witnessed the stigma and the scorn attached to the unwed mother. She is ostracised. Her life is made a hell. What is the alternative? It is the abortion trail to Britain. What do we do to stop it? Pious rantings and ravings about promiscuity and contraceptives never stopped one single life being aborted.

Mr. D. Andrews

I think that is painting a rather black picture.

Dr. O'Connell

With due respect, I have seen it at a much closer level when girls have come to me out of fear. Generally in our society the pregnant unmarried girl has been so ostracised because of the mores we have established in our society that she feels she must run off. Over and over again hundreds have come to me. I have tried to persuade them to stay here by telling them that I would try to ensure anonymity for them by getting a false address for them in London to which their parents could write. Not too long ago one girl came to me whose brother was a priest, and I thought that surely he would understand when I spoke to him. I had to find an anonymous place in Dublin for her to have her baby and get a false address for her in England.

What are we doing about all this? We are doing nothing. I had no back-up services at all for these people. The Church must come in for criticism for its failure to come to grips with this problem. It was only when I started out on this campaign of highlighting, month in and month out, the ghastly statistics of the number of abortions on Irish girls who went to Britain that CURA was established to give people some help and guidance in this critical hour of their lives. Only a doctor knows the crisis in a girl's mind. She will almost attempt suicide. Her whole life is changed and she finds herself so helpless. We have no back-up services. These girls come from small villages and towns. This is what is happening here and we have, by our very standards and our saying that there must be no contraception, pointed the way to Britain for an abortion. We, as a society, must take the blame for what has happened to so many thousands of Irish women journeying to Britain to look for abortions.

In the light of that we can hardly afford the luxury of indulging in righteous indignation. We have failed in the past and we are failing in the present to create the type of society which will cherish all children equally regardless of circumstances of birth, a society in which an unwed mother could have her child at home without being ostracised by the self-righteous.

As editor of a weekly medical magazine I had been trying to highlight these ghastly statistics and to break through the pious complacency that surrounded the problem. I had been attempting to discourage people from turning the blind eye. What have the restrictions on contraceptives achieved? Have they decreased the number of abortions? Would we prefer to see unmarried girls on the abortion trail than have a situation in which there were contraceptives available to prevent such pregnancies in the first place? That is the stark choice.

The Irish Family planning Association have done a great deal in preventing an increase in the number of abortions among Irish women. The association have provided advice, counselling and contraceptive devices but the future of the clinics is to be left to the discretion of the Minister. He will decide whether they are to be licensed and they will not be in a position under this legislation to receive donations for contraceptives which is the only form of income they have for financing their operations. Because of this and the other restrictive clauses in the Bill I foresee the virtual closure of these clinics. Is the Minister prepared to cope with the 40,000 or 50,000 people who attend these clinics each year? Is he in a position to assure the House that we have a sufficient number of doctors, trained fully in all the different methods of family planning, to cope with this massive influx? He cannot give any such assurance. He is not in a position to provide the services that the family planning clinics have been providing. Is he prepared to cope with the demands of the 35,000 people who receive through the post contraceptives from the Irish Family planning Association? Has he calculated the impact of these huge numbers of people attending at doctors' surgeries for prescriptions?

This Bill will prevent people from receiving contraceptives through the post. May we ask, then, what will be the position of those people who receive 12,000 condoms yearly through the post? What will be the position of people in a small village in which there may be only one chemist to dispense contraceptives on prescription but who, on grounds of conscience, may refuse to do so? Are our people to subject themselves to the squinting eyes of a parochial society? Will the whole village be informed of who is a sinner? Is the whole situation not reminiscent of Brinsley McNamara's "The Valley of Squinting Windows"? Have we any regard for the privacy and dignity of people? At least they are guaranteed anonymity by the services provided by the family planning clinics. Apart from a chemist opting out what is to be the position if the one doctor in a village opts out also on grounds of conscience? Where, then, is the all-embracing and comprehensive family planning service? The Minister has said clearly that doctors or chemists can opt out on grounds of conscience.

I oppose this Bill. It is being opposed by this party but should the legislation be steamrolled through the House by reason of the weight, moral or otherwise, of Fianna Fáil's 84 seats, we will have a political gesture but an inadequate provision for the present and future needs of our people. There is not any evidence of sex education in schools or in the public media that will inform people and prepare them for the fundamental and vital decision regarding family planning. All we have is a contemptible example of the politics of the possible. We should reject the Bill and the cynical mentality that brought about its introduction. It is that mentality and not the individual's right to contraception that should be stifled in this House. The Minister stated that he would have consultations with the Opposition parties.

Mr. Haughey

That is not true.

Dr. O'Connell

I apologise. Deputy Boland stated that the Minister had said he would have consultations with us on this matter. There should have been consultation with both parties in regard to this Bill. I have never been consulted on the issue. The Minister may say that it is a question of this Bill or of nothing. The situation is better than that envisaged in the Bill. At least there is a family planning service. The clinics are operating. The Minister could have provided a proper and comprehensive family planning service and considered it as part of the public health services to be operated by the health clinics in the same way as immunisations and pediatric assessments, for instance, are undertaken. Perhaps it would have involved a little extra cost to the Exchequer but we would have been providing a service not only in terms of family planning but for couples who have fertility problems and who could have consulted with doctors, nurses and other people concerned in this area. This would have involved a slight change in the Health Act but it would have been worth while. In such a comprehensive scheme people attending the health centres could be provided with whatever advice, information or contraceptives they required. We would have supported such a move and for once we would have been seen as a legislative body who are mature in our thinking concerning the needs of our people.

Now that we are in the EEC we should keep in line with thinking in Europe. There is pressure on us from Europe to produce a family planning Bill but I contend that we are being ridiculed by our colleagues in the other member states in relation to what we are doing in this area. I should have thought that the leadership would have come from the Minister for Health, bringing with him his backbenchers and, in turn, the people. If there is any party to do that it is Fianna Fáil but it is regrettable that they have failed to grasp the nettle. I am aware of the sort of situation that can exist in a village in rural Ireland but with a little more education in the whole area of family planning the Government could have come out of this situation much better and could have enhanced their prestige. But they have failed to bring in a comprehensive family planning Bill that would have ensured normal basic human rights for our people. What we want here is proper legislation but once something is on the Statute Book it may not be changed for a long time. It took 44 years, for instance, to even try to change the Criminal Law (Amendment) Act, 1935. It is not good enough, therefore, for the Minister to say that we will start off with this Bill because otherwise we will have nothing. Another 44 years will take us well into the next century. That is a long time to wait for basic human rights and, apparently, we have another 44 years to wait for them. That is a terrible indictment of our legislators.

Unfortunately, the Church here has contributed enormously to this sex-is-sinful syndrome. Everybody appears to be obsessed with sex, the mingling of the sexes, boys and girls mingling together. We have a lot to answer for because we have tried to keep the young girls and boys of Ireland apart. We have developed an unnatural approach to sex as such and this sex-is-sinful syndrome is very prevalent here as a result. The Church never speaks out enough against crimes of violence or other matters such as alcoholism, the biggest illness here but it is always sex, sex, sex. Nobody can deny that it was made clear to us all that sex was wrong. We were told that the natural thing was wrong and children were brought up with an unhealthy approach to it. That is what has distorted our way of thinking. We are recreating this situation because this is not an unnatural thing. It is a lovely change to see boys and girls of 15 talking to each other. Not too long ago such conversation was forbidden here; they were kept in different schools and we did not have a co-educational system. The results of all that can be seen in our thinking in this Bill. We are frightened now to come through because we know we have created this thinking among our people and are afraid to tell them that what they are thinking is wrong. We are afraid to tell them that they must change their thinking.

We have an opportunity to be legislators in the real sense of the word and to say that as legislators we are going to bring our constituents with us, not follow them. If we did that we would be respected by the electorate. Legislators need respect by the electorate but that is what is missing here. We capitulated on many issues. This morning we capitulated on the farm levy issue, yielded to the interests concerned. This capitulation is very bad and it is bringing this Chamber and the Government into disrepute. We are yielding on issues even though we know it is not in our best interests. The farm levy was introduced with the best of intentions and it could have been modified but now we have decided to capitulate. We need respect but we do not have it and are not doing anything to enhance our position with the public. Is it any wonder that people laugh at us and say: "One cannot trust a politician". It is a shame that that can happen.

The doctors will make a decision on this matter tomorrow. I am aware of the attempts that have been made to try, by every means possible, to get them to agree on this matter. In my view they would be making a grave mistake in supporting or even working this measure on behalf of the Minister. If they support it they will regret it. The consequences will be incalculable. They will go down in my estimation as an independent body who can speak for themselves. If that happens I could not in conscience look upon them as the special profession that they are because they would be pandering to the Minister. If that happens we will be going backwards and we could talk about people on arriving at Dublin airport turning back their watches 50 years. That is what we will be doing if we agree to the Bill and it is wrong that we should consider that. The doctors will lose my respect as a profession if they decide to operate the Bill. I want to make that clear, not on party grounds but because it is a farcical attempt to solve a serious problem. This Bill is making a mockery of the whole thing and because of that we have a duty to vote against it. I wonder if it is possible to amend it to make it workable.

I am concerned about those in the lower income group who need help. The general medical service patients are not provided for in the Bill. At present they can get the pill but not any other method of contraception. The pill is not the answer to contraception. It can be and is dangerous. The side effects are many and serious. We have doctors here ordering wrong oral contraceptives with too high a dose of estrogen. I do not think we should risk our lower income group to the hazards of the pill. They should be equally entitled to other methods of contraception free. We are offering them the pill.

Business suspended at 1.30 p.m. and resumed at 2.30 p.m.

Dáil Éireann debate - Wednesday, 28 Feb 1979

Health (Family Planning) Bill, 1978: Second Stage.

Dáil Éireann debate -
Wednesday, 28 Feb 1979