In underlying the reaction of the Labour Party to this Bill, I hope to deal directly with the suggestion contained in the Minister's speech that this Bill deals "in a responsible and acceptable way with a problem which has been a matter of political debate for the past six or seven years but which has not so far been resolved." I do not believe that this Bill deals in a responsible and acceptable way with the problem. At the time I did not believe that the Bill introduced by the previous administration dealt with the problem in a responsible and acceptable way. For a variety of reasons virtually all the political parties face two ways—in some cases three ways—on the question of family planning. There is no great internal agreement in the Fianna Fáil Party, there are differences of view in my own party, and substantial differences of view in the Fine Gael Party. That mirrors the disagreement which exists within the country among many shades of opinion on this important issue. For some people it is a very fundamental issue.
For the Minister to come into the House and say that this is "the first real Family Planning Bill" is a travesty of rational assessment of the Bill. For the Minister to say "the Bill now before the House genuinely merits the title of Family Planning" can only bring a hollow laugh, whether one has a medical mind or a mind trained in the social sciences or in legal affairs. By any analysis the Bill does not genuinely merit its title. I became quite irate when the Minister went on to suggest "This Bill is a Family Planning Bill in the full and proper sense of those words". Towards the end of his speech he said that the Bill is "a sincere attempt to meet the situation in a reasonable and acceptable manner". Finally he coined for all time the unique comment that this Bill "seeks to provide an Irish solution to an Irish problem". This stretches too far the extent of my personal credulity.
In some ways I have more regard for the document issued by the Order of the Knights of St. Columbanus, which was circulated to delegates at the Fianna Fáil Ard Fheis and also to Members of this House. In its erroneous nonsense this document is at least more honestly drafted than the Bill. It genuinely states the absolute error of its assessment. It states that where contraception legislation has been introduced premarital and extramarital sexual activity escalates, illegitimacy surprisingly, increases, venereal disease increases, legalised abortion is soon demanded to deal with failures of contraception and then the young are the first to suffer. At least that is a point of view. It is a point of view with which I totally disagree, but it is stated in an unvarnished way. The Minister attempts to suggest that this Bill is genuine, sincere, reasonable, responsible and unique to Irish law. We all know that the Minister does not believe this and neither do his departmental staff, the Irish Medical Association and rational politicians— though it is very hard to find rational politicians on this issue. It is time to examine why we must interminably discuss this matter in this manner.
There are some members of my party and very many people throughout the country who, for spiritual and religious reasons, believe that it is a sin to practice contraception in a particular form known as artificial contraception. They believe it to be a mortal sin in accordance with the teaching of the Catholic Church. If people have a religious faith of such strength, I entirely respect it. I do not believe contraception to be sinful or immoral and there can be differences of view in terms of one's faith. However, we as legislators must clearly draw the line when those who hold that contraception is immoral and sinful insist that their view be enshrined in legislation for all the people of the land, irrespective of their religion. I must add a crucially important point. When such persons say it is not only immoral and sinful but advance in support of their view alleged sociological and medical evidence, one can see sharply that the matter is open to rational dispute. I make that point emphatically.
I do not believe there is any great need to make contraceptives widely available either in slot machines, or barber shops, and so on. That is not necessary. I hold the view strongly that it is entirely reasonable and fair that contraceptives, and particularly non-medical contraceptives, should be available not only to married persons but also to single persons. Single persons, if they so wish, and if it is in accordance with their conscience, have a right to avail of contraception. Non-medical contraceptives, and Condoms in particular, should be available in chemist shops, in health board clinics, and in family planning clinics.
I have an open mind about the age limit. Perhaps it should be 18 years of age and upwards. I would not advocate it myself, nor would I wish to see young people involved in it, but it is legally permissible for persons of 17 years of age and upwards to have sexual relations. It is not a criminal offence. People have sexual relations outside marriage. That is a fact of life. I would not encourage that because I believe that, in their human relationships, people should act in as responsible and caring a way as possible. Sometimes one would almost believe that it is a criminal offence here to have sexual relations outside marriage.
I believe very strongly that this Bill will prove to be unconstitutional. I do not propose to go into the FitzGerald judgement on the McGee case, but one can presume that in future some unmarried men or women in their twenties will bring the Minister to court to test the section on the grounds that it is an infringement of their human rights. That vague, maladroitly-drafted section relating to alleged bona fide practices, whatever that means, before one can get an authorisation from a doctor, whatever “authorisation” means, will be declared unconstitutional, I have no doubt. One does not have to have any extensive training in legal affairs to come to that conclusion.
There has been an enormous amount of propaganda about abortion. I have been subjected to it over the past ten years in this House. I have received the most horrific multi-coloured photographs dealing with abortion. They have also been sent into my home where I have four young children. The sensitivity of the people who send them out does not extend to that. Gruesome photographs relating to abortion are their way of trying to convince me to oppose contraception. By and large they have been counter-productive.
Most Deputies can distinguish sharply between the issues of contraception and abortion. To his credit the Minister makes that distinction clearly. Although abortifacients are not defined clearly in the Bill, I do not propose to get involved with the Minister about that question. I am opposed to abortion. I could not support legislation in Dáil Éireann in favour of abortion but I can distinguish between legislation in that regard and legislation relating to contraception. Most Deputies are mature enough to understand the need to make that distinction between those two separate questions.
I want to commend the articles by Dr. David Nowlan, the medical correspondent of The Irish Times. He published three excellent articles. In one of the articles he included a table related to abortions in Britain giving residents of the Republic of Ireland and residents of Northern Ireland. He said:
The only point to make about the table is that the figures for the Republic are certainly substantially lower than the true state of affairs because it is known and has been shown, that many women from the Republic give English accommodation addresses when they go for abortions; and the Northern Ireland figures are probably subjected to the same bias. But it is trends that we are looking for. Does the ready availability of contraceptives lead to an increase in abortion rates?
He went on to refute the general assertion which is made by the opponents of contraception that, if it is available, inevitably it will lead to a demand for legalised abortion. It is disgraceful that some people have succumbed to that kind of irresponsible allegation in an attempt to decry the benefits which should be available to women in particular. As a predominently male Legislature we tend to underscore the benefits to women of contraception.
One of the aspects of family planning is that, generally speaking, it is advisable for people to have their families at as young an age as possible, if they are blessed with an early marriage, and if they are blessed with children. The older one gets the greater risk in terms of infant mortality or maternal death. Dr. Nowlan quoted a statistic which should go on the record of the House. He said that a study of 350,000 live births in America showed that maternal death rates rose from 5.1 per 10,000 births to mothers under 20 years of age, to 34.3 per 10,000 births when the mothers were over 40 years of age. In other words, he said that having your baby early in life rather than later is safer, and to achieve that will normally involve some kind of contraceptive activity, at least in the later reproductive years. There is no need to take the word of Dr. David Nowlan on it. There is a great deal of evidence from the WHO as well. That kind of evidence is widely available both in this country and abroad and is something with which every family, every family doctor and every gynaecologist will be familiar.
I come to another argument in favour of contraception. He went on to say that a study of infant deaths around the time of birth, carried out in Britain in the 1960s, showed that peri-natal mortality rates rose from 24.2 per 1,000 births on first pregnancy through 30 on the third to over 50 deaths per 1,000 births when the mother was in her fifth pregnancy. He pointed out then that the interval between births was shown to affect the percentage of births that were premature. I agree with his analysis here. It is of extreme importance to point out that the substantial medical, human and marital benefits from contraception arise where children come into life when the parents are relatively young and that the risk inherent in having children as a mother becomes older is substantially diminished. Secondly, contraception enables families to space births.
Thirdly, and of extreme importance, there is nothing more disturbing to any legislator in this House, nothing more awful in my experience and nothing more desperate in terms of trying to come to grips with it, than to notice a family in which a young child is not wanted by the mother, the father or both. Very often one is absolutely powerless to do anything about it, particularly as a politician trying to see how best that family might be encouraged. This can happen anywhere. In the absence of contraceptive advice a child may arrive who, for reasons best known to the individuals concerned, is not particularly wanted. It is very difficult for the vast majority of us to conceive of any situation where any child might not be wanted, but such are the vagaries of human emotion and reaction that this happens. There is substantial evidence to indicate that children who are unwanted very often become battered children. There is nothing more horrendous for most of us, and for all politicians, particularly those who served for any length of time, than to come across the case of a battered child perhaps every two or three years. It happens, and can be attributed to the fact that the family did not in any way practice contraception. The child arrived and there was not much thought about it. People acted in an irresponsible manner. They took chances and then that child had the most awful reception from its parents at the most formative period of its life. That is an argument in favour of contraception.
I do not want to overstate the arguments, but there has been so much propaganda against contraception that the positive, happier, more beneficial aspects of it have to be stressed. I do not get any pleasure or relief in a legislative sense in coming into this House having so to state. It is an appalling reflection on Irish society that one should have to say these things repeatedly to a country which prides itself so much on the Christian family and on the care of children in this International Year of the Child.
Therefore, the practice of contraception, provided—and one must continually enter the caveats—that it is not contrary to the personal moral beliefs of the families and individuals concerned who will under no circumstances practise it, can lead to a happier marital relationship. In the event of individuals who are not married having sexual relationships it can lead to a very substantial chance that children will not be conceived in that relationship. In that context we seem to be acting at least in a somewhat responsible manner, even if one suspends one's moral judgement as to the appropriateness or otherwise of what one is doing. I want to put that on record because I have found that the vast bulk of the material that I have received in the post has been so self-righteous and negative, and so assuming of the moral responsibility on our own behalf, that it seems to be the product of a rather Jansenistic concept of life which is so unhappy, so unloving and so negative, looking around corners to find evil and sin, that at times one begins to question one's own Christian beliefs. Unless one goes constantly to the positive, the good and the benefits, one could finish up being almost impaired by that kind of propaganda.
I come now to the nub of the Bill. Section 4 states that contraceptives shall be sold only by chemists in their shops and only to persons named in a prescription or authorisation given by a registered medical practitioner. I find section 4 reprehensible. I am surprised that a longstanding parliamentarian like the Minister, a man of such legislative experience, such knowledge of the ways of the world, a man who has had such considerable contact with the medical profession and such direct contact with the pharmaceutical chemists of the country since he became Minister should finish up with this repugnant formula to get around the sensitivities of conscience making a bad situation even worse. It is outrageous that one should say to a person seeking a non-medical contraceptive: "You must go to the doctor; you must advise that doctor that you want a non-medical contraceptive"—to use the parliamentary term for a condom. It is outrageous that one must say to one's family doctor—and lots of people, particularly young people do not have an individual doctor—"sorry, I am not married; I am here though for a bona fide purpose; I am not looking for 10 pints of Guinness as a contraceptive; I am looking for a condom; I want a written authorisation,” presumably on a piece of paper which will have family planning stamped on it, because presumably this will be subject to regulation by the Minister. That person will have to sit in the doctor's surgery, when the receptionist will come out and say to that young man, or woman, or married man: “What are you here for?” Of course, Ministers do not frequent surgeries; they are treated at a slightly more exalted level. But that receptionist will ask: “What are you here for; do you want your certificate; are you still on disability benefit?” Whereupon the unfortunate person will have to respond: “No, I want a certificate for a packet of condoms”, perhaps in front of 20 or 30 people. That person will be forced to tell the receptionist: “No, I cannot tell you what I want; I want to see the doctor privately. All I can say it that Morecombe and Wise will have little difficulty in having a free, rich source of Irish Paddy joke material. Probably it will come to that. Not only will it be unconstitutional, it will be hilarious. The unfortunate person, having received this notorious piece of paper—I only wish that poor old Myles na Gopaleen was alive today when he would have us in stitches; he would well outdo Man Bites Dog, Man Bites Doctor or whatever, in terms of analysis—must go to the local chemist who will look at him with jaundiced eyes in between dispensing bars of palm olive soap and, to the likes of me, hair restorer or something like that, and ask him what he wants, when the written authorisation will have to be produced. He will then get his supply—with again the big proviso—provided that chemist has not a conscientious objection, in which case the unfortunate devil at that point, probably in the extremity of the purpose for which he wished the said non-medical contraceptives, will have to travel another half mile or, if he happens to live in a rural town, will have to borrow a car and drive to the next town to get a replacement of supplies.
If it were not so tragic, so ridiculous, so dreadful in terms of legislation the situation could be funny but it is not. It is anything but funny, a situation in which one appoints the medical profession, the registered medical practitioners, the moral arbiters of the supply of a non-medical contraceptive, in which they are officially designated under this Bill. In that situation one must say to the Minister: do you really believe it; do you really think that is a genuine solution to an Irish problem as you stated in your final oration on this Bill? I suggest to him that it most certainly is not.
Of course there is an additional difficulty in this regard—the doctor and the chemist will be paid for all of this. Not only is the moral, family and individual privacy of the individual endangered, in the process, his pocket is fleeced. I presume the Minister will devise a system such as that under which one goes to a doctor and gets a repeat prescription, or the kind of thing that operates when one is on a course of injections. Presumably the Minister will devise some system under which an individual can obtain repeat authorisations without having to pay for them. I have not met very many doctors who will not demand another £2 or £3; one has to pay them. Nor do I know of any chemists around the country who will gaily distribute non-medical contraceptives without adding a prescription charge, whether it be 47p, 50p or whatever. Certainly they will demand payment as well. Therefore the unfortunate individual will have to pay out of his pocket, through invasion of his privacy and of course by exposure to the world of the purpose for which he seeks such contraceptives.
Of course a certain justification has been advanced by the Minister. It is of crucial importance that this House should endeavour to understand the rationale of the Minister as to why he has so designated the general practitioner-individual relationship. Let us listen to the advice of the Minister. He said of the doctor, if I may quote:
He is the person who most appropriately can give such advice and assistance since he is the professional person who knows most
I stress this—
about the physical and the 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.
As the Minister well knows, if one takes, for example, health board visitation statistics, the number of persons who visit their general practitioner annually is not very great. How many of us go to the doctor on a regular, annual basis or twice a year, three times or five times? How many doctors are aware of the physical and the psychological characteristics of the couple seeking their advice? Probably they are a young couple between the ages of 20 and 35 because the incidence of birth after 35 drops quite sharply. The couple may not be that well known to the doctor. To suggest, as the Minister does, that that is the reason this moral arbitration must devolve on general practitioners, to suggest that that is the profound reason for such distribution of non-medical contraceptives is less than honest and I do not believe that the Minister believes it.
Furthermore one is confronted by a situation in which the rationale advanced by the Minister mentions the word "couple"—the "couple" seeking his advice. We then have this unique piece of vocabulary, "the couple". What is meant by "the couple"? Is it a married couple, an unmarried couple, or a widower and the lady with whom he is consorting? As I understand the legal definition of the term the latter are considered "a couple". There is no reference in any part of the Bill to the word "couple". It merely uses the phrase "a person". Suddenly, and magically, "a person" becomes "a couple". The Minister could not get permission from the Government to introduce a Bill except it was explicit throughout it that married people would get contraceptives, but not single people. He could not put that into the Bill because he knows it would be unconstitutional. It is implicit in the section relating to the issue of contraceptives for bona fide purposes that it will have to be married persons.
The Minister hopes to slide out under a constitutional action on this matter. Section 4 (2) states:
A registered medical practitioner may, for the purposes of this Act, give a prescription or authorisation for a contraceptive to a person if he is satisfied that the person is seeking the contraceptive, bona fide, for family planning purposes...
The subsection then went on to deal with "the couple". The Minister carefully did not include the words "married couple" because he hopes we will be all very good boys and not embarrass him. He holds the view that we have enough egg on our face in relation to our previous efforts and hopes we will allow him get this Bill without any rigorous analysis.
I find that section particularly objectionable. It is medically unnecessary to devolve such a responsibility on GPs. Every doctor knows it is outrageous to suggest that they should have to issue a written authorisation for a non-medical contraceptive. That is the widespread view of the medical profession. Medical surgeries are overcrowded and overworked enough without having hundreds of people coming from family planning clinics seeking contraceptives because they are obliged to do so under the Bill. Whatever the excuses advanced by the Minister, it is even more invidious that those unfortunate people, customs officials, should be placed by the Minister in a similar position. It must bring a wry smile to some customs officers in relation to the Minister. Customs officers will have to decide whether the quantities of contraceptives are sufficient for the traveller's own use. I recall a former Minister deciding to try to put a numerical limit on the quantity that would be permitted for personal use. Needless to say, apart from appearing as a note on the file it did not get very far at Cabinet level; they had enough sense not to be drawn into that argument.
It is outrageous to place that onus on customs officers. It makes a laughing stock of those unfortunate people who have enough to administer in terms of trying to ensure that arms and ammunition and other illegal contrabands are not brought in. Presumably, a principal officer in the Department of Health, or the Department of Finance, will have to give such people guidelines. Will it be a couple of dozen or a couple of gross? What will the limitation be? Will there be an age limitation? If an unmarried young person under 25 is found in possession of contraceptives and declares they are for his own personal use, what will the situation be? If the customs officers find that he has 34 dozen and asks the person concerned how he can claim they are for his personal use, what will the situation be?
