I would like to withdraw amendment No. 17 as it is before the House and substitute amendment No. 17a which has been circulated with the list of amendments.
Health (Family Planning) Bill, 1978: Committee Stage (Resumed).
Debate resumed on amendment No. 17:
In page 3, subsection (1) (b) (i), lines 49 and 50, to delete "and the sale is at the place where he keeps open shop" and to substitute "for the compounding and dispensing of medical prescriptions in accordance with the provisions of the Pharmacy Acts, 1975 to 1977, and the sale is at the place where he so keeps open shop or at a place where family planning services are made available under section 3 of this Act".
—(Minister for Health).
Amendment, by leave, withdrawn.
I move amendment No. 17a:
In page 3, subsection (1) (b) (i), lines 49 and 50, to delete "and the sale is at the place where he keeps open shop" and to substitute "for the compounding and dispensing of medical prescriptions in accordance with the provisions of the Pharmacy Acts, 1875 to 1977, and the sale is made at the place where he keeps open shop or he is such a pharmaceutical chemist, or dispensing chemist and druggist, as aforesaid, and the sale is made, in connection with the service provided by the person in keeping such open shop as aforesaid, at a place where family planning services are made available under section 3 of this Act".
I apologise to the House for being a little late. Could the Minister give some indication of the effects of the substitute amendment?
Amendment No. 17a will make clearer what I want to achieve. Both amendments Nos. 17 and 17a deal with the sale of artificial contraceptives in clinics. As I explained the last day, amendment No. 17 has two purposes. The first was to bring the definition of "open shop" more into line with the Pharmacy Acts and the second was to provide that where a family planning clinic was being established, it would be possible to have artificial contraceptives sold at such a licensed clinic by a pharmacist or a chemist.
It was indicated to me that this would create a situation where it would be possible for a family planning clinic to employ a pharmacist and a chemist as agents and that was not my intention. Therefore, I am substituting this amendment to make it absolutely clear that if there is a licensed clinic which wishes to sell artificial contraceptives, this could be done only by a pharmacist or a chemist as an extension of his existing pharmacy. In other words, the amendment indicates that it must be an extension of keeping open shop in accordance with the Pharmacy Acts.
In other words, what the original amendment set out to do has been superseded by this amendment, which is entirely different. Some of us had hoped that when the Minister would produce this amendment he would be presenting a rather clever if devious way around the difficulties into which he had put family planning clinics in the original Bill. The effect of the original amendment No. 17 would have been to allow pharmacists sympathetic to the operation of the clinics to appoint the people in the clinics as their agents and to allow them consequently to sell or distribute contraceptives.
Some of us felt that that was a rather clever way the Minister had employed to meet the case made by the family planning clinics. By the time the Minister introduced the amendment as opposed to the stage of originally tabling it, events had taken place somewhere else which appear to have changed the intentions of the Minister, and the speech he made when introducing the amendment suggested that he had never had that intention and that if necessary he would have to revise the amendment. Deputy de Valera's remarks then also appeared to indicate that the Minister had some difficulties elsewhere.
This substitute amendment would have the effect of reverting to the position before the original amendment. As I understand it, the only effect of the substitute amendment will be to allow a pharmacist to operate a family planning clinic if he attends there personally, if he operates his pharmacy in the place where the family planning clinic is being carried out. That does not meet the needs of the clinics, and from that point of view one can speak more in sorrow than in anger. I do not believe the Minister is particularly pleased at having to introduce this substitute for the original amendment. It represents a further disimprovement to an already unacceptable concept.
Having seen this amendment I must withdraw the accusation I made on the last occasion that this Bill is a public relations exercise, a charge to which the Minister took exception. The longer I listen to this debate and the longer I study what is before us, the more plainly evident it becomes that the Bill is something he wishes to be shut of at the earliest possible opportunity because it is doing him and the Government increasing political damage. Nowhere is this clearer than in this amendment.
I do not know if I am right in thinking that he introduced the original amendment by saying he was doing so at the request of the pharmaceutical organisation who deal with the legislative aspect of the profession rather than remuneration and so on. It is now clear that the Minister's original amendment had a far more liberal intent than he or the profession intended, and that this substitute amendment is before us to try to correct that situation and to produce a situation in which, first of all, the family planning clinics as at present constituted will be able to continue in operation only if they receive the approval of the Minister and the Department, and second, if they wish to sell ordinary mechanical methods of contraception, they will have to employ a pharmacist and have that pharmacist on the premises.
This looks like a way out of the difficulty, but in fact it creates far more difficulties. It is difficult to see how the Minister could have avoided that, because the logic of the basic premise behind the Bill has led him into a more and more ludicrous situation. Let us be clear about what is involved in this amendment. It is not just a simple question of allowing pharmacists to dispense condoms and other non-mechanical contraceptives at family planning clinics. Looked at in another way, the Minister is forcing the clinics to employ pharmacists if they want to go on providing the vast majority of their customers with ordinary mechanical methods of contraception. The cost implications of that for these clinics are immense.
The implications are that family planning clinics outside Dublin will be wiped out overnight because they simply have not got the money to employ pharmacists or to pay pharmacists for attendance on their premises. Family planning services within Dublin could keep going for another year or two if they were to exhaust their reserves, but their span of life would be abbreviated and eventually terminated.
It is not as if the clinics, to the best of my knowledge, have the remotest intention of complying with this draconian measure. I do not believe they will, and I do not believe the Minister will extract himself from this difficulty by putting down this amendment. It is a draconian measure. I do not know how much pharmacists get paid these days, but when you take this amendment together with the section of the Bill which empowers the Minister to recognise certain clinics, we have a situation in which the Minister is saying: "Right, you can have your licence and go on distributing contraceptives as before as long as you employ a pharmacist".
As I have said, I do not know what is the going rate for pharmacists, but I suspect it is anything from £6,000 upwards. Therefore, what we are talking about is a licence fee for each clinic of £6,000 a year. Contrast that with the cost of a licence to sell alcoholic drink which is about £4 or £5 a year—I doubt if it is in double figures though I understand the Government were considering putting it up recently—and you find that this is a penal imposition on the family planning services which they will reject as a reasonable way out of the difficulties in which this Bill places them.
My final point in relation to the amendment is that the money which they might have to consider spending as a result of it if they want to continue to provide ordinary mechanical methods of family planning will have to be paid to pharmacists. At the moment, that money, the profits which they make on the sale of these products over the counter, goes back into the service on a non-profit basis to subsidise education training and, if necessary, the free supply of these materials.
Therefore, we are talking about an amendment whose logical consequence is to divert from the family planning service into the pockets of pharmacists revenue which should be used for the best interests and the best development of the family planning service.
Perhaps the Minister will tell us that things are not as bad as they appear to be. It seems possible to me that a pharmaceutical chemist could make an arrangement with a clinic on a sessional basis to provide a dispensing service, because that is all he has to do, in respect of prescriptions made up by the doctor in charge of the clinic. This, at first glance, extraordinarily vindictive insistence on putting the greatest number of impediments in the way of family planning clinics which are carrying out their work is very hard to understand; it is frightening. The Minister, listening to people who have made contributions to this debate, and having given the matter some thought himself, and knowing the problems of providing family planning as he does, and as nobody else in the country does, appears to have made an attempt at a working compromise. He went to the trouble of circulating the amendment in the Dáil, got to the stage of debating it, and then he is humiliated because it seems that it is the Minister who has been humiliated. He is our expert on this; he is the Minister for Health here. He has all the facts, as none of us has the facts, and he came to certain conclusions in the light of those facts.
He brought in that amendment, which was likely to be used in the way that Deputy Boland and Deputy Horgan and I suggested it could be used. As soon as that is made clear he is then publicly rebuked by a Cabinet who have already betrayed him by allowing this extraordinary decision of evasion of Cabinet responsibility—but we shall deal with that later. He is humiliated in that way and now there is the further humiliation of a Minister who is attempting to behave in a mildly liberal way, not a great liberal way. We see the intervention of the extremely intolerant group representing, I suppose, the natural family planning lobby which is so powerful, through the Knights of St. Columbanus and various interests which they use to control their lobby in Irish public life and he is made to bring in this Bill.
Presumably there must be some point at which a Minister will not continue to accept this type of regrettable behaviour by his Cabinet—this public vote of no confidence. We would have to accept that the Minister was not the best person to decide these things in the light of all the pressures put upon him. We were prepared to accept this as a compromise, which would help to preserve the clinics. Now we find it was not from the Opposition that the resistance has come to the Minister's liberal attitude, it is from behind him and from his own Cabinet. Surely there must come a time when the Minister would have to consider his own position in that situation?
On the question of these private clinics, everybody knows that I have been a socialist all my life and consequently I believe in the use of the State in the operation of this kind of activity, but I have never in the time during which I was in charge of the Department thought of closing down private organisations or enterprises which were working well, because of the defects in the service in many ways. I felt that if they were doing a job I had already enough on my plate without looking for more trouble in closing down these clinics and I encouraged them in whatever way I could.
It defies understanding how a Minister—knowing, as he does that there are perhaps ten doctors in the whole of the country competent to give serious advice on family planning—at a stage where he is proposing to provide a national family planning service, in the absence of any service whatever with the exception of the service provided by these private clinics, or private enterprises, or whatever you like to call them, would think of closing these. They are extremely efficient and are carrying out a very badly needed service under very great difficulties and supplying the needs for which he is Minister. Leaving aside the political consideration, it is his responsibility as Minister to provide a service for the people for whom he is Minister for Health. Surely that must be the first consideration. The political considerations and the differences within the Fianna Fáil Party, and the disgraceful pressures to which he appears to have been subjected, should not be allowed to interfere with his responsibility to provide an efficient family planning service.
I cannot repeat too often that the Jansenist influence in Irish Catholics seems always to come down to the fact that because people enjoy sex there is something wrong, or bad, or evil in it. That does not concern me at all. What concerns me is the issue raised, which motivated the introduction of this Bill, in the McGee case. It is a shame that the Supreme Court should have to tell us to make that law. If you remember the McGee case, it represented a matter of life and death to the particular lady; if she could not obtain contraception, she could have lost her life and it was generally believed she could have if she had another child. What is being debated here is a Bill which, in its effect, is one which could mean women losing their lives and children losing their lives—avoidable maternal mortality and avoidable neo-natal mortality and all the other things we talked of from time to time. These are demonstrable facts; I produced the figures, as did other Deputies, also, to show that this is the most important issue affecting women since the State was formed, not to mention the effect in relation to children, thousands and tens of thousands of unwanted children who are born every year in this country. I have already made my case for making this very harsh statement. It is possible now, because of the advances in science in relation to family planning and the control of fertility, to ensure that children brought into this very terrible, frightening world should be only the children of a loving relationship and children who are wanted. It appears that we can talk, argue and question in Opposition and do our best to attempt to defend the interests of the people we are concerned about, women who are faced with unwanted pregnancies or the children who are faced with being brought into a world where they are not wanted, but in the final analysis none of us can influence any of the decisions taken. There is only one person who stands between these people and the distress, tragedy, avoidable illnesses, hardships, sufferings and even death and the kind of law that would protect them, the Minister. I should like the Minister to give careful thought before he allows this very reactionary lobby which is obviously pressing him so hard within his party to gain control.
Can the Minister say why we have this rigmarole about "open shop"? What is so important about a chemist having to be a chemist in charge of an "open shop"? What will be dispensed are medical contraceptives such as IUDs, caps and spermicides and, in the non-medical area, condoms. I tried to introduce this question of the medical and non-medical contraceptives during the Second Stage debate. I believe a case could be made for a very competent professional level of individual being in charge of dispensing the apparatuses involved. In relation to the non-medical contraceptives no such case need be made. The dispensing of condoms can be done, and is being done, by slot machines. I should like the Minister to explain why it is that we have to have this very detailed provision about having to own a shop. What is wonderful about owning a chemist shop rather than being a chemist who has gone through the college of pharmacy and has the necessary qualifications? What is important about owning a shop before one is allowed to dispense condoms? Why is it that an ordinary qualified person on leaving the college of pharmacy cannot do that? The same applies in relation to the medical contraceptives because those who qualify at the college of pharmacy must be competent to dispense medical or non-medical contraceptives. Whatever about medical contraceptives it is absurd to try to suggest that the chemist dispensing condoms must own a shop. Can the Minister justify that? What case did those people make to the Minister to make it so important that only those who own a shop can dispense condoms?
I would be obliged if the Minister would define the term "open shop". May such a person have his supplies in a family planning clinic in the same way as he has them on the shelves in his shop? The Minister should explain the legal implications of having a shop.
I arrived in the House during the course of the contribution of the speaker who contributed prior to Deputy Browne. I was not aware of the Order of Business until I arrived here and, for the record, I should like to state that I was not aware that this Bill was being taken today. I did not receive notification of that until I arrived. I tabled a number of amendments to sections 10 and 16 and I should like to know what has happened to them because it appears that we are now considering a later section.
We are on section 4.
Are we considering amendment No. 17a submitted by the Minister?
Yes.
I do not wish to delay the House unduly on this amendment but it is as well that I should repeat my approach. It would be simple for me to draft a Bill which would meet with Deputy Browne's approval but I do not think such a Bill would be passed by the House. Secondly, in this whole business I have placed on myself an obligation to bring as many people with me as possible. This is a sensitive and delicate area, an area about which diametrically conflicting views are passionately held by many people. I regard it as my onerous duty to try to bring as many people with me as possible in an effort to achieve as broad a consensus as possible. The Bill is based on a simple straightforward principle, that the question of family planning is treated as a medical matter and the availability of artificial contraceptives is confined to a doctor's prescription and sale through a chemist's shop. There is no point in any Deputy railing against these provisions because the only thing they can do is vote against the Bill. This principle is at the heart of the Bill, it is the principle on which the Bill is based. I have found a most general level of acceptance throughout the community for that principle and I believe it is a defensible principle.
I have asked the House to imagine what the reaction would be if I had not transferred family planning matters from the Department of Justice to the Department of Health. If I had not involved doctors and pharmacists fully I can quite clearly visualise the string of complaints there would be that here I was taking something that should be, strictly speaking, a medical matter where the advice of doctors, chemists and nurses was needed, and dealing with it in some other way. So I do not make any apology for trying to bring family planning matters into the context of medical, nursing and pharmacy advice. That is the principle on which the Bill is framed and this amendment is following through on that principle.
Deputy Eileen Lemass made the point that if there was to be a licensed family planning clinic under medical supervision it was perhaps a bit unreasonable to expect a patient of such a clinic who got a prescription for an artificial contraceptive to go off some distance to procure the object and perhaps come back to the clinic to have further treatment in regard to it. It is in order to meet this eventuality that I am making the provision so that if a pharmacist wanted to extend his business to the clinic he would be able to do so and as part of his pharmacy and chemist business he could supply artificial contraceptives on a doctor's prescription at the place where the clinic was being provided.
I would like to point out one thing to Deputy Browne and in particular to Deputy Horgan. Implicit in what they are saying is that the right way to run a family planning service is to have it financed from the sale of artificial contraceptives. That is the corner they are forcing themselves into. I do not think that stands up. Whatever the position about the particular clinics that the Deputies favour up to now, when this legislation is passed an entirely new situation will prevail. These clinics came into being when there was no family planning service provided by the Department. This legislation now places a statutory obligation on the Minister for Health to provide a family planning service on a national basis and it is in that context that these questions must be examined. It is in that context that the question of whether or not any family planning clinic will be licensed.
As Deputies know it is my thinking and my approach that family planning services will be, in the main, provided by the general practitioner, the experienced, knowledgeable, skilled family practitioner. That is my belief. Family planning should reside with these people. I do recognise and it was implicit in the Bill from the beginning that there may be circumstances in which a general practioner service would not be able to meet needs. Therefore, we have provided in the Bill that there can be, under licence, family planning clinics and this is a step which is an extension of that. It is said that if we are going to have licensed family planning clinics with prescriptions available in them from doctors it is not unreasonable to enable pharmacists to supply artificial contraceptives in these clinics for the convenience of the persons concerned. I do not think it is anything to get terribly excited about particularly when at the moment this very important service must be provided if we want to have anything like a comprehensive health service here. It is a service which perhaps should have been provided long ago on a national basis. Advice, consultation, help, encouragement, sympathy and understanding are all involved in this important service. If we are going to have this, surely it is desirable that we should contemplate for the future the absurd situation that has applied up to now, namely, that a family planning clinic wishing to provide this service can do so only out of profits provided by the sale of artificial contraceptives. That is undesirable in principle and what I am proposing here is ultimately in the long term far more reasonable.
If I do, as I must, provide a comprehensive family planning service on a national basis, is that not the right way to do it rather than relying on a situation which could only have come into being because of the inadequate state of the law up to now? I recommend the amendment to the House. My attention was focused on it because of a conversation which I had with the representatives of the pharmacists and they could see difficulties in the Bill as it was originally framed. When I came to look at it, it seemed reasonable that in exceptional circumstances it might be necessary to license family planning clinics and it might be desirable to have artificial contraceptives made available somewhere convenient to the family planning clinic and this was a reasonable way of doing it.
The Minister has said that the obvious and correct way would be to provide a national comprehensive family planning service and that if that were done the question of the clinics dispensing or selling contraceptives should not arise. I would entirely agree with the Minister but he knows very well that the effect of this Bill will not be to provide a national comprehensive family planning service in any way and consequently as some of us had hoped would be avoided, some people will be put to unnecessary expense and trouble in having to go to a doctor first and pay for the cost of the visit to the doctor and, secondly, in having to go to a pharmacist and pay the full retail cost that the pharmacist chooses to impose on the sale of the contraceptives. This will put an additional and in some cases an unacceptable financial burden on poor people in particular. For that reason and because the Minister's Bill does not set up a comprehensive national family planning service some of us felt that it would be better if the clinics that were being allowed to operate were also allowed to sell contraceptives at a reduced price which would be to the benefit of the people who had gone to them for advice and which would have the additional beneficial effect of allowing the clinic to continue in being.
The Deputy knows that the position is that they can only finance themselves by engaging commercially in the sale of contraceptives.
But I do not see that the Minister is suggesting any way to financially assist those clinics to continue in operation. If the Minister were suggesting, as part of his licensing arrangement under section 3, that he is going to give financial assistance to such clinics as he sees fit to license, that would be an entirely different situation because then we would be considering the position where the clinics were being assisted by the State to operate. It still is not getting over the difficulty that certain people will find themselves in of having the financial burden of visiting a doctor and visiting a chemist at his shop and paying the appropriate fees in each case, and those people have benefited up to the present through the reduced cost which contraceptives are sold at in the family planning clinics.
If the Minister sees fit under section 3 to license a clinic he will have to be well satisfied about the standard employed in the clinic, the training of the personnel who would be available and its entire modus operandi. It is right that that should happen. I accept that in any legislation clinics which are operating should have some kind of licensing arrangement from some Government agency to ensure that they operate to a high and acceptable standard. Once those clinics are licensed by the Minister it means that he is satisfied that they will operate to that high standard. I would have thought that if he was so satisfied that they would operate to a high standard and in an acceptable fashion it ought to have been possible to allow the clinics to sell contraceptives. It would be only those clinics which the Minister was satisfied were above board and operating in an efficient manner which would be allowed to operate under licence at all. In that case the Minister should feel satisfied to allow them to sell.
It is almost certain that any clinics which might be licensed would be under the control of the health boards. One of the things the health boards made clear to me was that they did not wish to be involved in the sale of artificial contraceptives. There is that difficulty.
I accept that. In section 3 the Minister obliges the health boards, if he is going to introduce any kind of national service to them to make family planning clinics available within the health board structure. In section 3 (3) (a) it is stated:
A person other than a health board may, with the consent of the Minister and in accordance with regulations for the purposes of this subsection, make available a family planning service, not being exclusively a family planning service such as is referred to in subsection (2).
The one referred to in subsection (2) is a natural family planning clinic. It is under section 3 (3) (a) that the Minister has the right, and I am assuming will exercise the right, to license certain clinics other than health board clinics. Those are the ones we are talking about. It is not being helpful to confuse the issue by bringing us back into the area of the health boards.
There are a lot of unacceptable and unpalatable things that some of us involved in public life are obliged to do from time to time. I am quite certain it would make life easier for the health boards to operate family planning clinics that did not make contraceptives available but I am not certain that that is the right course of action for the Minister to take merely because the representatives of the health boards, for the sake of having a quiet life, should make the point to him that they did not want to be involved in the dispensing of contraceptives. In 1974 the Minister's colleagues who spoke on the Bill introduced at that time were all tending towards the suggestion that the only clinics that should make contraceptives available were ones operated by health boards. Party colleagues of the Minister and party colleagues of mine who serve as members of health boards and executives of health boards would all see that it would be an easy operation for them if they merely had to make advice available but not actually make contraceptives available. That does not necessarily mean that the Minister of the day should decide to acquiesce.
The Minister ought to have looked more carefully at that and have said to the health boards that he accepted they did not like the idea of doing this but for the sake of providing the best possible service and control to a high standard they would have to make contraceptives available through health board clinics. That is the corollary to the argument put forward by the Minister in relation to health board clinics.
Is the Deputy speaking for himself or for the main Opposition party? The views the Deputy has expressed are some fundamental policy views and it would help us to know whether he is speaking for himself or his party. Could the Deputy clarify that?
It does not need clarification.
I would like an answer to my question.
The Deputy will get it.
The Deputy is mischiefmaking at present. It would be a good idea to treat the subject as one that must be resolved as satisfactorily as possible in the light of the differing and conflicting views held by different people. We should make things as easy as we can and not difficult.
The Minister said he did not see why we got excited about this. We only did so because we thought he had done something which was an advance on a very unsatisfactory situation. We welcomed his decision to try to make it possible for the clinics to survive. It is not a situation of choice held by these people. If the Minister could give us an enforceable undertaking that if he accepts the professional standards of the level of services being provided in a particular clinic he will fund the service we have no further question or conflict. One assumes that the money would be provided to any pharmacist whether it is the one with the shop or the one with the degree. The Minister should make clear what his attitude is about that.
The health boards extraordinary decision that they would like to provide advice on contraception but not provide the appliances is an absolutely absurd situation which they cannot possibly be permitted to maintain. This is what being a Minister is about: making decisions which sometimes people do not like. They must be made if we are to advance. The public health service in the early years of the State did not want to have medical officers of health in many health authorities. The then Ministers had to persuade them that it was important for them to do this kind of thing. The health boards have been providing contraceptives for a number of years through dispensing the pill. Why they should decide to dispense one kind of contraceptive and not another is simply childish. This kind of thinking should not be tolerated. The job is to provide a service for women which is in the interests of their health. The Minister has made the point the whole way through that it is based on the need for medical advice. It is a medical question. It is in the interests of their health and a health board who do not feel they can provide the facilities to people who pay for the running of these health boards, the taxpayers, and have this curious sense of punctilio about providing one kind of contraceptive——
On a point of order, may I draw the attention of the Chair to the fact that there is not a quorum of Members present? If certain people are going to be political we will use the political rules now.
Notice taken that 20 Members were not present; House counted and 20 Members being present,
Did the Deputy opposite call for a quorum so that he could answer Deputy de Valera's question? I was sitting in the Public Gallery and I thought that was the reason Deputy Boland wanted a quorum.
That is dead right. I will do so when Deputy Dr. Browne has finished speaking and I will stay here to do so.
The health boards probably do not particularly want to expand the contraceptives service and facilities. For many years in the Eastern Health Board we had our pharmacy. Incidentally, it was not an open shop and I wonder does that in any way contravene the Minister's provision in the new amendment. It was a very closed shop because there was a full-time pharmacist whose job it was to provide whatever we as doctors prescribed for patients. Of course, part of the time we prescribed contraceptives in the form of cycle regulators as being the only ones available. That was certainly done. From now on we can provide all the different sedatives, narcotics, thymoleptic drugs, and all the different medicines which may be made available for the one thousand and one ailments to which people are heir. We can write prescriptions which will be sent down to the health board pharmacy, and prescriptions for all of these medicines and drugs and appliances can be filled with the exception of prescriptions for contraceptives.
This is advice which the Minister simply wants to take. It is the easy road for him to take. I do not think he should, and I do not think he can. It is unthinkable that somebody should have to go to a separate chemist half-a-mile from the hospital, or even a few hundred yards from the hospital, while at the same time all the drugs, medicines and appliances other than contraceptives can be made available by the hospital pharmacist. The Minister might like to consider the question: does that constitute an open shop and is that person competent under the Act to provide contraceptive appliances?
The Minister will have to take a stand on that where the health boards are concerned. Could he give us an undertaking that he will fund any registered clinic? Could he put in an amendment on Report Stage or give us an assurance in some way that he will fund any approved registered health clinic? If it were a matter for the health board to finance them, and if that were permissible under the Act, nobody wants people to go on making money out of contraceptives if that can be avoided.
Notice taken that 20 Members were not present; House counted and 20 Members being present,
I want to query the Minister on the issue raised by Deputy Browne and raised previously by another Deputy. On the question of the establishment of family planning clinics for which health boards do not wish to have any responsibility, a plea has already been made for making available certain artificial contraceptives at a low cost. I want to place on record my serious objection to any such plea. People have their own views, and I have my views on this matter. I cannot associate myself in any way with the plea which has been conveyed to the Minister. In the event of a patient having to obtain a prescription for contraceptives, there should be no question of one penny piece of taxpayers' money being spent to lower the price of contraceptives or subsidise them in any way.
Some health boards have already made strong representations to the Minister on this matter. Many members of health boards, officers and executives, feel they are bound in conscience not to recommend nor to be associated with the supplying of artificial contraceptives. I believe that the vast majority of taxpayers would object strongly to part of their taxes being used to subsidise artificial contraceptives. Is it any wonder that some hundreds of thousands of Irish voters are disgusted with parliamentary democracy? Having regard to current trends I do not think that we will have parliamentary democracy for very much longer.
I appeal to the Minister to put this Bill on the shelves of his Department and to leave it to become surrounded by cobwebs because there are many vitally important economic and national problems to be dealt with. Artificial contraception is morally wrong. Have we lost our minds?
The Second Reading has been completed. The Deputy should deal with the amendment.
Parents cannot be denied the right to plan their families and to help them in this matter the Minister should give his full support to those clinics at which there is provided advice on the natural methods of family planning. Very strong representations have been made to the Minister in this regard. However, not a penny of public money should be made available to subsidise in any way those clinics which provide a family planning service that is not based on the natural methods. The Minister has referred to the availability of sympathy, advice and understanding but such sympathy, advice and understanding can be provided readily at natural family planning clinics. There is no need for legislation to provide for the development and the expansion of such services.
I must remind the Deputy that the principles of the Bill are not under discussion at this stage. We are on an amendment to section 4.
I agree, but in view of what has been said already I should like to place my views on record. It is a matter of indifference as to how the Minister may try to cloak the availability of artificial contraceptives by stipulating where they can be sold. He should know that to make them available is wrong in every respect and this House is wrong to endeavour to legislate in any way for the making available of artificial contraceptives. The Minister must be aware that the majority of the health boards do not wish to be associated with the provision of artificial contraceptives. There has been the suggestion that artificial contraceptives would be made available on medical prescriptions by the health boards. We must ensure that the taxpayers' money is not used to subsidise what is wrong morally but I am sure no taxpayer would object to the subsidisation of clinics at which the natural methods of family planning only were advocated.
Some time ago I was asked whether I was speaking on this Bill on my own behalf or on behalf of my party. This is the first opportunity I have had of replying to that question.
On Second Stage I explained at considerable length that I was speaking on behalf of my party, but I explained also that this party had held traditionally that anyone who had a disagreement with our attitude on the basis of personal conscience was free to abstain from the party attitude and to come here and enunciate his views. I pleaded again, as I have pleaded before, that that same spirit might be allowed to permeate on the Government side. Deputy Flanagan and others will be able to confirm that I have gone to the trouble of encouraging those who disagree with my point of view to come here and put forward their point of view. In that way there could be a meaningful discussion here.
Perhaps when I am asked whether I speak on my own behalf or on behalf of my party by somebody who was not present to vote at the end of the Second Stage debate on this Government measure, it may be by somebody who has sat like a Richelieu on the Minister's shoulder since Committee Stage of this debate began. Perhaps when I am being asked by somebody who obviously is the main proposer and proponent of amendment No. 17a it might be considered inappropriate. Earlier today when speaking on amendment No. 17a I said that I spoke more in sorrow than in anger because I sympathised with the Minister who had endeavoured to improve this Bill——
The Deputy has had ample time. He might now deal with the amendment.
I said that I sympathised with the Minister who had endeavoured to improve the Bill and that I did not believe that it gave him any personal pleasure or satisfaction to be forced by the rump of his party in here to introduce a substitute amendment which negatived the only liberalising move initiated by the Government since this measure was introduced. We have seen evidence of the Richelieu and the rump of the Fianna Fáil Party here this afternoon. I regret that there has been an attempt to make cheap political gibes here at my expense or at the expense of any other Member. I tell the Deputy de Valeras of this world that it will not wash. I speak on behalf of my party as my party's spokesman on health and social welfare as long as I am that spokesman. When the Minister for Agriculture did not come into this House to vote at the end of Second Stage was that on behalf of his party?
This is not in order. The Deputy will please deal with amendment No. 17a.
Deputy de Valera's intervention was not in order.
I gave Deputy Boland an opportunity to reply, not to make a long speech.
I appreciate that and I accept it. I want to explain and to apologise to Deputy de Valera's colleagues for the fact that I called for several quorums. I have never before done so, but if someone attempts to make cheap political gibes at my expense or at the expense of my party he will suffer the political consequences. Those gentlemen in the Government benches who have been disturbed from their sleep can thank their colleague, Deputy de Valera, for the interruption. Is Deputy C. Murphy satisfied with his answer? Congratulations to him on having successfully elected Deputy Kavanagh to Europe to make his own path easier in the county he represents. Is Deputy de Valera satisfied? Will he now get up and tell us why he was not here to vote at the end of Second Stage for his Minister's Bill?
We had better get on with the Committee Stage debate.
He has sat like a Richelieu on the Minister's shoulders since Committee Stage of this debate started.
We will now get on with the Committee Stage debate.
As the Deputy did, I am inviting him——
The Chair is not accepting invitations.
Can we have a quorum to hear the pearly drops of wisdom that may fall from Deputy de Valera?
Notice taken that 20 Members were not present; House counted, and 20 Members being present,
I have two questions for the Minister. He recognises the existing family planning clinics and he has no objection to recognising them. His Department permit moneys to be spent by people who attend them because of the quality of the service in the form of lectures, instructions and so on given in these clinics. Given that he does recognise the existing clinics and it would be an extraordinary act of folly to close them down—and they must close down if they do not find the money—will he be responsible for providing the finance to save them the necessity of finding money for contraceptives? If he is not able to clear that point, may a pharmacist who keeps open shop allow his assistant to act in the capacity of a dispenser in a family planning clinic of prescriptions made up in that family planning clinic? Is it permissible for an assistant not the owner of the open shop to be the person who dispenses? If an assistant is permitted to act as dispenser why cannot an ordinary assistant with the same qualifications act in that capacity?
The approach is that it is the pharmacist himself who will have to attend at any licensed clinic.
Does the Minister see any objection to an ordinary young person coming out of college with a degree in pharmacy acting in a family planning clinic if needed to do so? Is there any professional reason to object to that?
No, if the person complies with the legislation if it is an extension of the open shop.
But it would have to be extension of the open shop?
Yes.
My second question to the Minister was about the funding of the service it is agreed to register to avoid the need for finding their own finance.
The Deputy knows that I have not taken any decision at all yet as to whether any clinics will be needed. It is my intention that the family planning service will be provided primarily by the general practitioner, the family doctor. That is the principle enshrined in the Bill. Naturally, we have to be reasonably prudent and we have to recognise that in many of these clinics there may be areas, perhaps sectors of the population, which would not be catered for by the general family doctor, particularly in view of the fact that we have the conscientious objection clause in the Bill. Therefore, as a precaution it is provided in the Bill that where public interest demands it clinics may be licensed. I would see a distinction. If there is a statutory obligation on me as Minister for Health to provide a comprehensive family planning service on a national basis, then certainly in so far as that national family planning service would be involved it would be part of and integrated into the general community medical care service and whatever funds would be involved would be made available for the provision of such a service, just as the Bill provides that we can make research grants available for research into natural family planning methods.
Another principle which I have enshrined in the Bill so far is that public funds will not be provided for the provision of contraceptives for family planning purposes. If certain medical preparations are made available at the moment for medical reasons as distinct from family planning reasons, that situation will continue. It is not my intention that artificial contraceptives as such should be provided or subsidised in any way from public funds.
How will the Minister distinguish whether the prescription is genuinely for family planning purposes?
I have already dealt with that on a number of occasions. That is a matter for the professional judgement and discretion of the medical practitioner.
I am glad to have that on record again.
If the Minister registers one of the existing clinics, which we all know are providing first class services, they will have only one way of funding themselves and that is through the sale of contraceptives which the Minister apparently will not permit anymore.
Any clinic which might be licensed under this legislation will only be licensed for the purposes of the legislation and will have to comply with the legislation.
That is fair enough, but can the Minister say then that if they are licensed we can assume that they can employ a person under the Act and the Minister will fund the moneys needed?
I have not yet decided whether any clinics will be licensed. That is a matter for decision.
Is amendment No. 17a agreed?
The Minister did not have an opportunity of dealing with the point I made some time ago, which was that a clinic obviously would have to be operated at a high standard before he would licence it and, that being the case, if the Minister was satisfied that it would operate at that high standard he might also consider allowing the clinic operatives to sell contraceptives.
That is a matter for future decision as we create a comprehensive national family planning service. I certainly do not visualise a Minister for Health providing public moneys for the operation of private clinics nor would anybody in this House visualise that. That does not apply in the health services in any way.
The confusion about public moneys being provided arose because the Minister was at pains to say that he felt it wrong that family planning clinics should have to rely for their finances on the sale of contraceptives. By implication it appeared that the Minister might consider making some money available to help in the operation of those clinics. The Minister has now made it clear that that is not his intention.
The question I asked the Minister, which has still not been dealt with, is whether when the Minister is licensing those clinics—and we all accept that he would only license clinics which he felt were operating at a very high standard—he will then allow the operatives of those clinics to sell contraceptives. The Minister has now suggested that as he tries to develop a comprehensive national family planning service that eventuality might arise. That eventuality will be excluded from ever arising if this Bill in its present from and this amendment in its present form are enacted. There is no let-out clause and there is no way whereby the Minister can allow the clinics to sell contraceptives under this Bill as amended by amendment No. 17a.
Is amendment No. 17a agreed?
Surely the Minister will have a set of regulations calling for certain rigid standards in relation to these clinics?
That is the idea of the licence. The Deputy must not assume that clinics will be licensed. The legislation is quite specific in that it is only if it is shown that it is necessary in the public interests that there should be a clinic that the Minister can license a clinic.
I am happy about that.
In relation to the Minister's apparent shock and horror at the idea that he should have to pay for the operation of a clinic providing a much-needed service from public funds, surely the Minister does not see anything——
Funds for private clinics. To provide public funds for private clinics would be a whole new departure in the health services.
The Minister is not doing that and should not attempt to do so.
Possibly the Minister is confused but he must know that I would be the last person to look for money to be provided for private clinics from public funds. I am only concerned for the kind of service provided in the existing family planning clinics which may go out of operation unless they are funded in some way. Quite obviously what we usually did, as the Minister will recall from the 1947 Act, was that we allowed for the funding of the voluntary hospitals from public money. That was a sensible compromise. It would have been absurd to try to start up a completely new hospital service, so obviously a compromise was arrived at by the then Minister which works extremely well. What I have in mind is that these clinics should be absorbed into the existing health service to provide a service for the people for whom the Minister is responsible and that the Minister would pay in the ordinary way under the accepted principle. Surely the Minister sees nothing wrong with that, assuming that he agrees to register the clinics to which I refer.
We appear to be getting into a very wide debate on this amendment. Is the amendment agreed?
No. I have a certain fear that because there is a difference of opinion between Deputy Browne and myself, Deputy Browne might think that I am being difficult and cutting across his views in relation to this. That is not so. Deputy Browne is entitled to his opinion and is entitled to express it, as I am entitled to express mine. Because we both express views and totally disagree does not mean that that is being done for reasons other than that we are both sincere about expressing our views.
Is the amendment agreed?
No. I am still not clear about it. Whatever else one might say about the Minister for Health he cannot easily be described as being incompetent. The Minister has not made it clear why amendment No. 17a replaced amendment No. 17. When the Minister proposed amendment No. 17 he suggested that the effect of it had been subsequently brought to his attention after he had entered it on the Order Paper for discussion. I would not dream of describing myself as being in any way near as competent as the Minister but within 20 seconds of reading amendment No. 17 the effect of it was quite clear. I do not see that the Minister can fairly ask the House to believe that he did not realise that amendment No. 17 would have the effect which it would have had and ask the House now to agree to this substitute amendment which has an entirely different effect. The House deserves a more comprehensive answer than the Minister gave.
Is amendment No. 17a agreed?
Will the Minister not——
I have explained on countless occasions, and also when I was introducing the original amendment No. 17 which is now being withdrawn, that it had been drawn to my attention that it could have the effect of somebody other than a pharmacist involving himself in the sale of artificial contraceptives. I wanted to bring this section exactly into line with the fundamental principles of the Bill and that is what amendment No. 17a does.
Amendment No. 17 is no longer before the House.
Is the Minister telling the House clearly that he personally never saw the effect amendment No. 17 would have had until it was drawn to his attention, that it was not his intention——
The amendment was drafted by the draftsman. It was only after it was published that it was drawn to my attention.
Amendment No. 17 is no longer before the House; it was withdrawn by leave much earlier this afternoon. We are now dealing with amendment No. 17a.
I have a much higher regard for the competence of the Minister and the draftsmen than to be asked to believe——
Well, the Deputy must believe what he wants.
——that the intention of amendment No. 17 was not apparent to the draftsman or to the Minister or his staff when it was introduced here.
We would have to say, in relation to amendment No. 17a, that it is fairly clear, and became clearer this afternoon, that from the time amendment No. 17 was published to the time it was moved by the Minister, certain of his colleagues who also read it and saw its effect, were not prepared to support it and who apparently were not there in sufficient numbers to force him to change his hand. From that point of view, I said at the outset that I spoke more in sorrow than in anger in relation to the matter because I felt that the Minister must feel uncomfortable and unhappy that his original intention was changed. I am now faced with a situation of being asked by the Minister to accept that that was never his original intention. I do not believe he is that incompetent.
I want to say quite categorically that it was never my intention that anybody, other than a pharmacist, should sell artificial contraceptives; it was never my intention that that should happen. That is what has been in the Bill from the beginning. That is what is now being made absolutely clear by the substitute amendment No. 17a. There is no argument about that.
An Leas-Ceann Comhairle
May the Chair make it clear again that amendment No. 17 was withdrawn ages ago?
Amendment agreed to.
Amendments Nos. 18 to 24 inclusive have been ruled out of order.
Question proposed: "That section 4, as amended, stand part of the Bill."
On a point of information, did the Chair say amendment No. 22 was ruled out of order?
An Leas-Cheann Comairle
Yes. Amendment No. 22 is ruled out of order. I understand the Deputy was informed to that effect. In a letter delivered to Deputies it was stated that amendments Nos. 18 to 25, inclusive, were ruled out of order. Deputy Boland, on section 4 as amended.
Let us just vote; there is no reason to discuss it further.
I received one piece of helpful advice already this afternoon that held up the passage of the Bill by at least half-an-hour. If the Minister wants to start on the same path——
No, I am only making a practical suggestion. We have discussed every single aspect of this section, every single possible up and down, in and out of it. I do not think any of us is going to convince anybody else of any further point on it.
Deputy Boland on section 4, as amended, and the Chair must point out that repetition is completely out of order.
We have not even begun to discuss section 4——
That is a gospel of despair—that we ought to be convincing one another.
We have not even begun to discuss section 4.
The Minister is the only Fianna Fail member not in despair at present.
Obviously the Minister has been involved in detailed discussions up and down and every way on section 4 somewhere else in the last few weeks. Perhaps he is confusing those internal discussions with a discussion that has not yet taken place in the House.
Of course, it is a terrible thing that the time of Parliament should be wasted on a Family Planning Bill when the country is in economic chaos, when this should be the last thing we should be discussing.
Hear, hear, I could not agree more.
Deputy Boland is in possession on section 4 as amended.
(Interruptions.)
A simple one line amendment to section 17 is simply all that was needed.
That is all.
Deputy Boland would not vote for that.
Would Deputy Gibbons?
The Minister has a majority of 20.
Deputy Kelly was right, then.
I never said he would not be let vote for that.
Deputy Boland is in possession.
It appears now that even the Minister, whom I thought understood the position, has even misunderstood the position of the Fine Gael Party. He suggests the Deputy would not be let vote for a simple one line amendment to section 17 of the 1935 Criminal Law (Amendment) Act.
(Interruptions.)
Now, hold on——
Sorry, it does not arise on this section anyway.
I made it clear already in this House several times, and had to do so at some length for Deputy Vivion de Valera this afternoon, that the Fine Gael Party would allow its members to vote in whatever way they wanted, and that if that vote was not in accordance with party policy on the matter but because of a personal belief or as a matter of conscience, they would be entitled to do so. Here again the Minister seeks to misinterpret——
My only suggestion——
We must get back to section 4 now.
All those fellows over there are very testy today.
No, it is Deputy Boland who is testy this evening. I do not think the party spokesman, whatever about any other member of his party, can oppose.
By the way, I am not going to——
I think it is time the Chair got testy at this stage. Deputy Boland on section 4.
I want to speak at some length about the use of the phrase "bona fide" in this section.
So do I later on, for a long time.
We have had a particular problem in relation to the use of the phrase "bona fide" in subsection (1) (b) (ii) which says:
the person to whom the contraceptives are sold is named in a prescription or authorisation in writing for the contraceptives of a registered medical practitioner and is a person who, in the opinion of the practitioner formed at the time of the giving of the prescription or authorisation, sought the contraceptives for the purpose, bona fide, of family planning....
The phrase is used again in subsection (2). I wonder if the Minister could assist the House in explaining, first, why the phrase "bona fide" was used and, secondly, what he means by its use.
Is section 4, as amended agreed?
Sir, I asked if the Minister could help the House by explaining to us why he used the phrase "bona fide" in several different parts of section 4 and what is meant by the phrase in that context.
Exactly what it says, in good faith.
Why did not the Minister use the English language then?
It is a well known drafting phrase. I have already explained this frequently. If I might refer again to what I said on 9 May at column 273 of the Official Report of that day:
By "bona fide family planning" I mean the genuine decision of a couple in a family context to make those decisions.
In fact I said at columns 272-273:
As to what I mean by "family planning", I mean the ability of a family to decide the number of children they will have and the spacing of those children. By "bona fide family planning" I mean the genuine decision of a couple in a family context to make those decisions.
The Deputy can make what he likes of that.
I wondered why the Minister had used this Latin phrase "bona fide" and had not used the ordinary English language.
Again, when it comes to this sort of thing, it is the draftsman's decision that prevails. The use of the phrase "bona fide" in this Bill is a matter decided entirely by the draftsman.
My reason for asking was that the Minister's colleague, Deputy David Andrews, speaking on the Committee Stage of the Landlord and Tenant Bill in the Seanad on 28 March said, at column 989, in relation to the phrase "bona fide":
It is just a piece of superfluous jargon which lawyers are inclined to use.
Because some of my colleagues in the Seanad were endeavouring to have the phrase "bona fide" reinserted into the Landlord and Tenant Bill there was a subsequent debate on the phrase in the Seanad on 2 May in which the Minister's attitude to using any Latin phrase, but in particular the Latin phrase "bona fide", can only be described as scathing.
I always endeavour to restrain my inclination to display my classical education in this House.
Progress reported; Committee to sit again.