Before proceeding with the Bill I must remind the House of the decision made just now on the Order of Business that 15 minutes only be available to each speaker.
Health (Family Planning) (Amendment) Bill, 1992: Second Stage.
I move: "That the Bill be now read a Second Time."
I am very pleased to bring this legislation before the House. It is an issue which has been the subject of much debate for some time and one which I felt needed to be addressed as a matter of urgency. The legislation is required urgently for two reasons. First and most importantly, for public health reasons and, second, to bring our family planning legislation more in line with current public mores and thinking.
I would like to outline why the measures in this Bill are necessary for public health reasons, in particular as a means to tackle the problem of sexually transmitted diseases, including HIV-AIDS. As the House will know, HIV-AIDS is a relatively new disease, being recognised as a specific entity only within the last ten years and it was only in 1985 that laboratory testing for the HIV virus became possible. There are a number of well-recognised risk factors associated with the spread of the disease of which the two most common in Ireland are intravenous drug abuse and unprotected sexual intercourse with an infected partner.
Over the past number of years almost 1,250 people have tested positive for the HIV virus in this country, 276 people have developed full-blown AIDS, according to the internationally accepted definition, and 114 people have died. It is very probable — indeed, almost certain — that the pool of infection in this country is much larger than that reflected in these official statistics. For a variety of reasons, a number of people who have engaged in high-risk behaviour do not come forward for testing. In addition, because of the international mobility of people, particularly between here and the UK, people who will have had positive tests in other countries and are now resident in this country may not feature in the official statistics.
It is of paramount importance that the spread of the HIV infection is curtailed, and a range of recommendations have been made by the National Aids Strategy Committee towards this end. These recommendations have been accepted by me and are being implemented. They include broadly based public education programmes together with specific initiatives aimed at targeted sub-groups who are considered to be at particular risk. Coupled with these educational strategies, however, must be the recognition that people will continue to be sexually active and that further practical measures need to be taken to prevent the spread of the disease. It is universally recognised that a good quality condom, properly used, does provide significant protection against the transmission of the virus. The wider availability of this protective measure must be seen, therefore, as a practical and sensible contribution to the prevention of its spread.
Similarly with other sexually transmitted diseases, the network of sexually transmitted diseases clinics set up over the past few years in areas such as Dublin, Cork, Galway and Limerick, report an increasing number, of young people particularly, using their services for advice, counselling, diagnosis and treatment. Between 1986 and 1990 notification to the Department of Health of STDs such as gonorrhoea, herpes genitalis, non-specific urethritis, chlamydia, syphilis, trichomonas in all have shown a 45 per cent increase. In St. James's Hospital alone the numbers attending STD clinics have risen from 9,755 in 1988 to 13,758 in 1991. While many STD infections, unlike HIV-AIDS, are amenable to treatment and cure, diseases such as gonorrhoea can have devastating long term effects such as sterility and infertility and are, therefore, not only a cause for public health concern but a source of tragedy and despair for many individuals and couples.
From a purely medical and public health point of view, the prevention of transmission of these diseases is a matter of serious concern not only to my Department, but also to the wider community. The wider availability of condoms, coupled, of course, with educational initiatives, has a major role to play in this endeavour.
The Bill also updates to a very considerable extent many of the provisions of the Health (Family Planning) Act, 1979, which itself was amended somewhat by the Health (Family Planning) (Amendment) Act, 1985. The 1979 Act was designed in its time to deal in an acceptable and responsible way with a problem which had already been a matter of debate for some years and had culminated in a Supreme Court decision which involved a fundamental change in the law relating to the availability of contraceptives.
The Government in 1979 decided to avail of the opportunity, when introducing legislation made necessary by the Supreme Court decision, to legislate also for a full family planning service. It made provisions, inter alia, for: the orderly organisation of family planning services and the provision of a comprehensive natural family planning service; the making available by health boards of a family planning service, which, I might add, was defined as a service for the provision of information, instruction, advice and consultation in relation to any one or more of the following: family planning, contraception and contraceptives; the sale of contraceptives in certain chemists' shops to persons named in a prescription or authorisation given by a registered medical practitioner. The doctor had to be of the opinion, in giving the prescription, that the contraceptives were being sought for the purpose, bona fide, of family planning or for adequate medical reasons and in appropriate circumstances. The doctor had to indicate this on the prescription. The Act also made provisions regarding the licensing of importers and manufacturers of contraceptives; the advertising and display of contraceptives and the funding of research into certain methods of contraception.
The 1979 Act was seen at that time as an appropriate legislative initiative, given that it set out a structure for the organisation of family planning services and introduced controls considered necessary at the time with regard to the sale of contraceptives.
Regulations made in 1980 required health boards to make available a family planning service and indicated the requirements to be met in relation to family planning services provided by other bodies. They dealt with the issuing of prescriptions and authorisations for contraceptives, their importation and their advertising and display.
The Health (Family Planning) (Amendment) Act was introduced in 1985. It amended the 1979 Act by extending the right to sell contraceptives to doctors, employees of health boards, licensed family planning clinics, maternity hospitals and hospitals providing services for the treatment of sexually transmitted diseases. The Act provided that condoms and spermicides could be sold without prescription to persons over 18 years of age from the specified outlets.
Under the Programme for Economic and Social Progress it was agreed that the operation of the family planning services will be kept under review in association with relevant organisations. In view of this and the significant rise in the incidence of sexually transmissible diseases and of the incidence of AIDS here the Government in 1991 applied themselves to formulating legislation to provide for greater availability of condoms while at the same time respecting the concerns of many groups and individuals, not least parents.
This led to the publication of the Health (Family Planning) (Amendment) Bill in July last year. This Bill provided for (i) an increase in the range of outlets permitted to sell condoms and certain spermicidal preparations; (ii) a reduction in the age limit at which persons could buy condoms and certain spermicides, without prescription, from 18 years to 17 years; and (iii) the removal of the anomaly whereby pharmacies which were limited companies were legally prohibited from selling contraceptives. It provided that condoms could be sold without prescription or authorisation provided that (i) the purchaser was over the age of 17 years; (ii) the vendor was over the age of 18 years; (iii) the sale was not by way of vending machine and (iv) the sale was either from one of the existing approved outlets selling all contraceptives, that is pharmacies, family planning clinics, hospitals and so on or from a premises registered by a health board. The Bill provided that if, on the application of an owner or occupier of a premises, a health board were satisfied as to the suitability of the premises for the sale of condoms and certain spermicides, then they could approve the premises for such sales. It also provided that each health board would be required to establish and maintain a register of such premises.
Where a person was convicted of an offence under the Bill, or where the health board considered that his premises was no longer suitable for the sale of condoms and certain spermicides they could withdraw their approval and remove his name from the register. The particular provisions with regard to the role of the health boards attracted considerable comment of which I do not need to remind the House.
When I was appointed Minister for Health I indicated that one of my priorities would be the fight against AIDS. In the short term I have been in office I have overseen the completion of a set of recommendations from the National AIDS Strategy Committee and provided funds for their implementation. I would like to take this opportunity to formerly record my appreciation of the work done by the National AIDS Strategy Committee. Their recommendations underpinned my own views with regard to many of the initiatives which are required to deal effectively with the transmission of the disease, including the need to take action to reduce the spread of HIV/AIDS through sexual contact.
I very quickly looked carefully at the Health (Family Planning) (Amendment) Bill, 1991, to ensure that it dealt adequately with the serious public health problems and, as I said earlier, in the context of bringing the provisions of the 1979 Act more into line with current thinking and practice in so far as family planning issues, per se, are concerned.
I appreciate the concerns which the Government had last year in bringing forward the 1991 Bill and I have retained many features of it in the present Bill. I have always felt, however, from my own experience and in the light of views which have been expressed since it was published, that a number of changes in this Bill were necessary. I am very pleased to acknowledge the full support which I have received from the Government with regard to this issue. It has been accorded priority attention because of the major public health issues at stake and of the Government's concern that all action be taken to tackle the spread of HIV/AIDS.
I intend to take the House through the Bill section by section but at this stage I would like to signal the main changes which I have introduced to the 1991 Bill.
First, I have removed the provisions with regard to spermicides. In the 1991 Bill it was intended that condoms and certain spermicides would be widely available without prescription. This provision had followed from the 1985 Act which, as I outlined earlier, had allowed condoms and spermicides to be sold to persons over 18 years of age. The decision in 1985 was taken in the context of the desirability of using spermicides with certain condoms for contraceptive purposes. Spermicides, however, have no prophylactic effect other than as contraceptives. They do not prevent the spread of sexually transmissible diseases. In fact I would be concerned that were they to be used mistakenly for such purposes they could lead to the transmission of such diseases, including AIDS. The Bill provides, therefore, that spermicides will in future come within the definition of a medical preparation to be governed by the provisions of the Health Act, 1947.
Secondly, in section 3, I am dropping the requirement that doctors must indicate on a prescription that a contraceptive is for the purposes, bona fide, of family planning. This provision originated in the 1979 Act when entirely different considerations prevailed. It is no longer considered appropriate to retain this requirement. I will return to this issue on Committee Stage when I will be tabling technical amendments.
Thirdly, I have lowered the age limit for the purchase of all contraceptives to 17 years and have eliminated the requirement that married couples should have to obtain a prescription to buy contraceptives. I have made provisions, therefore, in section 3 to exempt them from the prescription requirement.
Fourthly, I have dropped the role proposed for the health boards from the Bill. I have considered the background to the decision last year to provide for a registration system involving the boards. I can appreciate the concerns which led to that decision but I have come firmly to the conclusion that if we are to make condoms, which are not medical devices, more freely available we must have the least possible amount of red tape. Section 3 clearly sets out those places which may not sell condoms. Consequently any place not excluded may sell them if the proprietor so wishes. There is, therefore, no need for a registration system as it will be clear from the outset where condoms may be sold. I would hope that Deputies will agree with this approach but, as I said, we cannot hope to see greater availability of these prophylactics unless we have the minimum bureaucratic involvement.
A further change which I have made to the 1991 Bill involves the requirement that importers and manufacturers of condoms should hold a licence from the Minister for Health. I do not see this as necessary. Instead of requiring that importers and manufacturers of condoms hold ministerial licences I am introducing a provision, in section 3, which enables me to prescribe standards for contraceptives. It will be illegal to supply contraceptives which do not comply with these standards. This is a very important provision which was not in the 1991 Bill. If we are to make condoms more widely available we must ensure that the public is provided only with quality products. There is no EC standard for condoms yet but the issue is being considered in Brussels. There are, however, internationally recognised standards such as the BSI and I will be looking at these with a view to introducing regulations at an early date. I am anxious to hear the views of all Members on this very important Bill which aims to make condoms more freely available. However, I have had to take into account the concerns of parents, who may be a minority, but we must remember that we have a duty to protect minorities.
Not fundamentalist minorities.
I welcome the introduction of a Bill to deal with our family planning laws. However, this latest attempt by the Government to amend the legislation is a disappointment. The Government have not seriously faced up to the reality of the public health issues involved, on which the Minister eloquently touched in the course of his contribution.
As parents, we all, rightly, want to pass on moral standards to our children and it is not desirable that young people should engage casually in sexual relationships. Our health education programmes should support the efforts of parents in regard to this task. A society that loses sight of the values of responsible sexuality is building up huge problems for itself. However, it is folly to think that criminal law can be an effective tool in promoting responsible sexual behaviour. It is that error which undermines the Minister's approach.
It is an established fact that young people are becoming sexually active at a younger age in Ireland today, thereby exposing themselves to risks which were never contemplated by their parents' generation. Many young girls face the hardship of unwanted pregnancies and many have taken the sad, lonely passage to Britain to procure an abortion. Young people are exposed to the risks of sexually transmissible diseases and, as the Minister rightly pointed out, the huge and growing threat of AIDS is the greatest of those risks.
However regretful we may feel about the responsibility of the changed attitudes to sexual behaviour, we cannot ignore the clear indications for public health policy. However strongly we may feel about their responsibility of engaging in casual sexual relationships, we cannot but feel even more strongly about the irresponsibility of engaging in such relationships without protection, people thereby exposing themselves and their partners to enormous risks.
The Government today are insisting on an age limit which I believe the Minister knows is unenforceable. Indeed, this age limit could have a counter-productive effect. It could well be interpreted as suggesting that the State takes a different attitude to responsible sexual behaviour once people go over the age of 17. The Government insist that in no circumstances can condoms be sold from vending machines. If the Minister truly recognised the very real public health risks involved, which he described today, he would want to see those who are sexually active protecting themselves and their partners. He will know that purchasing contraceptives and condoms is an extremely personal matter. The wall of embarrassment which the Minister proposes to put up in this legislation is a far more powerful barrier than any prohibition he might issue. If those who are engaging in casual sexual relationships are to avail of protection, vending machines should be permissible in places where there are already legal restrictions on young people congregating, such as pubs and adult discotheques.
Sad to say, the Minister has also missed an opportunity to embrace the far wider reform needed in our family planning laws which contain provisions that can only be described as sectarian. He should have recognised the obligation of the State to provide a full family planning service not confined to natural family planning as the law now makes it. He should have recognised equally that the State should be supporting research that goes far beyond natural family planning methods. These are major public health issues for women today, and the Minister has missed an opportunity.
At the outset we should recognise what our task as legislators is. It is not to choose between any sets of moral beliefs nor is it to use criminal law to try to police any moral code. Our role is much humbler than that. We have to make decisions in the interests of the public good in a very imperfect world where people may subscribe to different moral beliefs and where many people lapse from the standards they set for themselves. As legislators we have responsibility to protect the rights of individuals to exercise their personal rights in freedom in a context that protects the overall public good. As parents we all want to pass on our standards to our children and we in this House must make greater efforts to support this. We need much more investment in teaching responsible sexual attitudes.
The churches, too, have a clear pastoral role to play on their own part. In advocating a law that makes condoms more widely available our party have no desire to see teenagers becoming involved in sexual relationships at young ages. Such a law is not giving endorsement to casual sexual behaviour. Indeed, one of our worries about the notion of an age limit is that it is much more likely to be interpreted by young people as an endorsement of different sexual attitudes once you reach the age of 18. We do not want to create a situation where people who have reached the age of 18 are thought to have been given an official licence.
It would be a mistake for the Minister to exaggerate the role of law in the changing sexual attitudes that have developed in Ireland. As he knows, up to 1935 there was no law restricting condoms in Ireland, but Ireland could not have been described as a centre of promiscuity. There has been a dramatic change in sexual attitudes in the last 30 years, I believe despite, not because of, our attempts to restrict that by legislation. To quote the late Professor John Kelly when he spoke in this House: "We may be winching down the gates faster than the waters are building up on the outside", as he described our efforts in 1985 to amend the legislation. It is clear at this stage that the waters have built up and are washing over our very outdated legislation.
Young people today face enormous pressures and hazards. We cannot overlook those dramatic changes in sexual attitudes and sexual behaviour in the world in which this generation is growing up. It is established that young people are becoming sexually active in younger and younger age groups. This is a serious source of worry at many levels. The Minister will know that last year over 2,000 babies were born to unmarried teenage mothers. I have no doubt that these children have brought great joy into their young mothers' lives. However, for many of those mothers it may have destroyed the opportunity of making full use of their young lives. All too often the evidence is there that they and their young children slip into serious deprivation. Last year also over 4,000 young mothers are recorded as having crossed to the UK to have their pregnancies terminated and 700 of these were in their teens. This was something not lightly undertaken and for all of them has been a deep personal tragedy.
Last year also 800 new cases were reported to the clinics for dealing with sexually transmitted diseases and those figures are well known to seriously underestimate the true position. The greatest and most menacing threat is the explosive growth in the HIV virus. As the Minister has stated today, official estimates put these figures at 1,250 but most commentators believe the true figures are at least two or three times that level. If present growth rates continue we could see levels of this virus reaching 20,000 by the end of the decade. However strongly we feel about changed sexual attitudes, these risks I have just described are of such enormous stature that we cannot but feel much more strongly about young people engaging in relationships without the protection they should be providing for themselves and their partners. It is of enormous importance that young people who engage in casual sexual relationships protect themselves and the means to do so must be available when and where they will be availed of. I do not believe the Minister's efforts today will achieve that.
However, we cannot delude ourselves into thinking that liberalising legislation —I hope the Minister will take on board amendments from the Opposition — is an adequate response to the growing problems I have described. Young people are coming under pressure from their peers to engage in casual sexual relationships at very young ages and their ability to deal with this pressure and to resist sexual involvement before they are ready to make a positive choice is directly related to their understanding of their own sexuality. Sad to say, our education system has not got to grips with the need to equip our young people to cope in this vital area of their lives. Education must impart to young people a self-respect and a respect for one another in their sexual relationships. It must give them the confidence to say "No" in an increasingly macho world. A proper programme of action in this area is a vital factor in the sort of legislation I hope we will adopt when this debate is over.
Some people say the availability of condoms will encourage people, who would not otherwise have done so, to engage in sexual relationships. It would appear that the Minister has taken to heart representations along those lines which he says he has got in enormous volume. Maybe because of more liberal legislation a small minority of people will become sexually active who might not otherwise have done so. However, we cannot accept that the preventable tragedy on the scale of HIV, or any of the other threats, should be the price that has to be paid by some individuals in order to get other people to behave responsibly. That whole thinking about the way in which we should approach this issue is flawed. The Minister should have taken the trouble to explain to those people who are making representations to him the scale of the public health risks involved and the alternative approach we must adopt if we want young people to have responsible attitudes. We must instil in our young people a sense of responsibility in sexual matters. Having done so, we must trust them to make their own decisions and not hope that shopkeepers can act as sentries, policing responsible behaviour.
The credibility of what the Minister is suggesting is coming under strain and has been the case of hilarity in the newspapers, especially in regard to the idea of people going into pubs or discos and asking for a packet of condoms and a pint of plain. There is a serious credibility gap.
The greatest barrier to using the protection which the Minister says should and must be used in a public health context is embarrassment. People will not feel happy buying condoms in that context. I believe the Minister shares that view. We are looking at a law which the Minister hopes will not be enforced. He hopes people will not take seriously the age limit and that sales will not be confined to over-the-counter mechanisms where ages can be scrutinised. If that is his approach and that of the Government, the former Deputy John Kelly's description of the attitude of the present Government party in 1985 still holds. He said the 1985 Bill was designed to permit the Government to sit smugly back with its hands folded over its stomach and say, "we have done our duty by the young people of the country."
This is not a true attempt to address this issue. The successive efforts of this House to reform family planning laws do not constitute a proud record. There are still elements of our family planning laws which cannot but be described as sectarian. Many of the elements of the old 1979 Act will remain intact after the passage of this legislation. The Minister remains obliged only to provide for natural family planning. His responsibility in relation to other services is merely to secure their orderly organisation. These sections have been used to limit public funds to family planning clinics which provide a comprehensive range of services. While under section 9 of the Act, grants for research are confined to natural planning which is of enormous importance in promoting public health, women have a right to proper advice on the alternative methods. There should be a duty on the State to provide such service and to gather information and research that can improve the quality of services and advice to women.
There is another part of the 1979 Act which is an anachronism. Advertisements are deemed indecent if they refer to sexually transmitted diseases, complaints relating to sexual intercourse or to the removal of irregularities in menstruation. How can this sort of restriction on information be defended by the Minister? This Bill is a sad disappointment. We will not oppose it on Second Stage but we will put forward amendments on Committee Stage which I hope the Minister will accept in a positive spirit.
The last time this issue was debated in Dáil Éireann was seven years ago. Most Members will recall the debate which concerned a Bill published by my party colleague, the then Minister for Health, Mr. Barry Desmond. The principal provision of that Bill was to remove the requirement of a doctor's prescription for the purchase of condoms and to allow them to be purchased by people over the age of 18. It was a modest provision, little more than an attempt to introduce some measure of rationality into the law of the land promoted by one of his predecessors as Minister for Health, Deputy Charles Haughey.
When the Bill was published on 7 February 1985 the then Archbishop of Dublin strongly criticised it, saying it would lead to premarital sexual activity, moral decline, increased incidence of venereal disease, teenage pregnancies, illegitimate births and abortions. Throughout the Second Stage debate in 1985 there was an atmosphere of considerable political tension. It was a time for either standing by the Republic or by strongly expressed religious and moral convictions. It was also a time for some of the most cynical and opportunistic posturing by a political Opposition in the history of this Chamber. The result of the debate was anxiously awaited by the people and, despite the strong and often scurrilous debate waged by the then Opposition inside and outside this House, the Bill was narrowly passed by 83 votes to 80.
In a real sense the publication of this Bill says something too. If passed in its present form, it will say that the seven years which have elapsed have not really informed us and that we as legislators in 1992 are still out of touch with the needs, attitudes and values of the people we are sent here to represent. The truth is that people have stopped listening to this Chamber and have gone about living their lives according to the standards they are setting for themselves. This Bill pretends to be about family planning. That alone makes it a Bill that does not matter to the lives of many people. People who want to plan their families will not look to the leadership of this House. They will get on with their lives and decide that the matter is a private one for themselves and their spouses.
The issue that does matter is the spread of a killer disease, and that is what the Bill should be about. It fails that test also at the very first hurdle. One has only to read the definition section to realise that for the first time in any Irish legislation the definition of "contraceptive" is being expressly widened to include condoms or contraceptive sheaths, as they are quaintly called in the Bill. From now on in Irish law, should this Bill be enacted, a condom will be defined as being for the prevention of pregnancy — it is a contraceptive, not a prophylactic. This is patently absurd. It alone makes the Bill a laughing stock. We will be the only country in the western world whose legislators have refused to recognise the prophylactic properties of a condom, which should be our main objective in the battle against AIDS.
Suspicions may arise in some minds that there may be an ulterior motive. The Virgin Megastore case in many ways emphasised the need for this Bill. In that case the defendants argued unsuccessfully that condoms were on sale as part of the fight against the spread of infectious diseases, particularly HIV and AIDS. The new definition strengthens the argument against the prophylactic use of condoms. This definition will give rise to further controversy in the future. In some European countries and in the United States there is on the market a new product, a female condom known as a femadom. Undoubtedly, it will be made available some time in this country. How is it to be regarded in the eyes of the law if this Bill is enacted? It is not a sheath, an oral medicine or an intra-uterine device. This is a good example of the failure of this legislation to address the realities which confront the people.
The Bill is absurd in other ways. Section 6 reclassifies oral contraceptives and makes them subject to section 65 of the 1947 Health Act which enables the Minister for Health to make regulations covering the sale and distribution of these products. Section 66 of the 1947 Act gives the Minister very wide-ranging powers to ban any or all products, including medical preparations. It is a section that I believe has only been used once to ban tobacco products, chewing or oral tobacco. It is believed that it was originally inserted in the 1947 Act because of a conviction in certain circles at the time that it would be necessary to persuade a Minister for Health to ban the use of tampons if they were introduced into Ireland.
A section inserted for that purpose is now capable of application by way of regulation to any oral contraceptive or, as the Bill makes clear, any preparation which can be used for the regulation of the menstrual cycle. It could be used, for example, by any Minister for Health who may decide that he wants to ban an oral contraceptive and forbid the sale of it in Ireland because it might be construed as being an abortifacient.
As I said, Ministers will have the power to ban oral contraceptives under the terms of this Bill. This is legislative hypocrisy and it will be seen as such by the great majority, particularly of the young people, whose cynicism concerning politics we deplore but whose cynicism we encourage by enacting legislation such as this. It is not the first time that Fianna Fáil in particular have deployed cynicism in relation to this issue. Who said the following:
A contraceptive society requires abortion as a fail-safe and that, if we were going to have obtaining a widespread liberal situation in so far as contraceptives were concerned, we would also have to place ourselves in the position of providing abortion as a backup to that service. Any society that has widespread contraceptives available is an anti-life society and it would be in contravention of the stated aims of our Constitution.
The speaker was the present Minister for Justice, Deputy Flynn, who was contributing to the debate on the Health (Family Planning) (Amendment) Bill, 1985, introduced by former Deputy, Mr. Barry Desmond, as reported in the Official Report of 20 February 1985, column 359. In the next column the same Deputy went on to suggest that contraception had a detrimental effect on veneral disease and that there were statistics available to back up that statement.
At the beginning of his speech that Deputy said that the Bill, "would constitute official recognition and give respectability to the use of contraceptives by all and sundry leading inevitably to permissiveness among the young."
If his fears for the future moral wellbeing of the young people were considerable then, he must be quaking in his shoes at the prospect of what will ensure from this legislation. However, he was not alone in 1985 in forecasting the direst of consequences in relation to the modest reform that was proposed. For example, his colleague, former Deputy Seán McCarthy, described that Bill as contemptible, reprehensible and of showing an appalling lack of judgment. Former Deputy Gene Fitzgerald told the House that the free availability of contraceptives to teenagers hits directly at the family unit which is the main support of society. Deputy Michael Kitt described the Bill as likely to undermine the values of young people. Deputy Tunney suggested that the Minister for Health had a personal vested interest in the legislation, and Deputy Noel Treacy accused the Minister of shunning his responsibility to promote natural family planning methods.
However, the pièce de résistance came from the Fianna Fáil spokesman on Health at the time, Deputy O'Hanlon, who went on to have a long career as Minister for Health. In a long contribution he never used the word “condom” but in the course of his speech in 1985 he described his party as “the Republican Party, representing all opinions with no particular sectional interest, a mature political party”. He then went on to say that the 1985 Bill would make contraceptives freely available to any teenager and he warned, “it is not possible to enforce the age limit. There is nothing to stop a young girl of 15 or 16 years of age going into a chemist shop wearing high heeled shoes and asking for contraceptives”. In short, he concluded that, “if this legislation is passed we in this House will be endorsing a pattern of behaviour which no responsible adult would condone”.
I greatly regret the truncation of the debate and I expressed that view last night. To limit the time to 15 minutes for each Deputy's contribution on a Bill of this importance is too short. I wish to say much more but I will reserve my contribution for Committee Stage.
I have a duty to represent all sections of opinion in our society, not one particular ethos, but to represent everybody. As a principle we should involve ourselves as legislators as little as possible in the lives of people and only when it is necessary. The Bill that we would wish to have before us would seek not to impose arbitrary, unenforceable age limits for the availability of condoms but, instead, would facilitate the widest possible availability of condoms to people who are sexually active. The Bill we would wish to see implemented would make it legal rather than illegal to disseminate information through advertising and other means about the efficacy of condoms in the struggle against AIDS and would set out to supplement such information with a proper and non-moralistic programme of education.
The Bill that we need would remove restrictions on vending machines and the difficulties already described in relation to the purchase of condoms. Unfortunately, this Bill is flawed in many ways. We will, however, support the Bill on Second Stage in the hope that between now and tomorrow the Minister will reflect on all that has been said by the Opposition Deputies and on his own feelings in this matter. When Committee and Report Stages conclude tomorrow I hope we will have a Bill that is in keeping with the times and that does not seek to be a throwback to a time long forgotten.
I am delighted to have an opportunity to participate in the Second Stage debate on this Bill. My colleague, Deputy O'Connell, the Minister for Health, has set out the background to, and the rationale for, the Bill. As he has indicated to the House, the Bill is a pragmatic, appropriate and balanced approach to the wider availability of condoms, in particular in the context of HIV-AIDS and other sexually transmissible diseases.
The Bill is primarily a response to these issues which continue to present problems to individuals, the community and the health services. AIDS was identified as a clinical entity in 1981 and diagnosed cases have been reported to the Department of Health since 1982. Serological surveillance of the disease became possible in 1985 and was initiated in Ireland on a voluntary, linked basis in September 1985.
The epidemiological development of AIDS and HIV in Ireland is similar to that experienced in other western European countries. From 1982 to 1985 cases were reported in homosexuals and haemophiliacs and the condition was seen as a largely imported disease. When seroprevalence monitoring became possible in 1985 it was apparent that the HIV virus was indigenous in the country and that a particular problem existed in relation to the spread of HIV infection in intravenous drug abusers.
To date we have 276 reported cases of AIDS which meet the CDC/WHO definition. Some 1,223 people have tested HIV positive. The percentage of intravenous drug-related cases is now 39.5 per cent of all cases as compared to 10.5 per cent in 1986. This movement of the epidemic towards the drug abuser has been accompanied by a steady increase in the number of heterosexual cases. Some 9 per cent of Irish cases are heterosexual. In 1986 we had no heterosexual cases in Ireland.
Positive tests are reported by the virus reference laboratory to the Department of Health each year. Of these, the number of heterosexual cases which have tested positive is increasing steadily. In 1986, 21 HIV positive heterosexual cases were reported. Since then, the numbers have increased to 148 cases to date. Interestingly, the number of tests carried out on heterosexuals has trebled between 1985 and 1992, increasing from 7,638 to 20,850. It is not unreasonable to conclude from these figures that there is a movement of the disease away from the groups traditionally considered to be most at risk of contracting the infection to the wider community. In addition, using the heterosexual figures as an indicator, it would appear from the statistics regarding the numbers tested than an increasing number of heterosexuals are considering themselves to have been at risk of contracting the infection.
As the Minister indicated, the figures in respect of other sexually transmitted diseases also support the need for wider availability of condoms. The numbers of attendances at the genito-urinary medicine clinic at St. James's Hospital have increased considerably over the past few years. In 1988 a total of 9,755 attendances took place. This increased to over 13,000 in 1990 and 1991.
The new cases of sexually transmitted diseases notified to the Department of Health under the Infectious Diseases Regulations, 1981 also show an increase from 2,891 in 1986 to 4,189 in 1990. Clearly, the framework for the availability of condoms provided under the 1979 and 1985 Acts needed to be updated to respond to the situation which I have now described. The use of condoms in the fight against AIDS-HIV, in particular, has been endorsed by international fora, such as the World Health Organisation and was addressed recently by the National AIDS Strategy Committee in their comprehensive review of our national AIDS strategy. The strategy committee highlighted the role of the condom as a primary measure in preventing the infection and it is incumbent on us, as legislators, to pay particular attention to advice of this nature.
In my capacity as chairman of the national co-ordinating committee on drug abuse I am presiding over the implementation of the Government strategy on drug misuse which was adopted in May 1991. This strategy took account of the twin problem of AIDS and drug abuse and strongly recommended the introduction of appropriate risk-reduction programmes aimed at minimising the spread of the virus in the community. I am happy that the co-ordinating committee's views are being implemented and that condoms are being promoted as a key component of this strategy also.
With reference to the provisions of the Bill specifically, the House will note that its primary purpose is to make condoms more widely available. This is done through the combined effects of sections 3 and 4 which reduce the age limit of persons to whom any contraceptive as defined in the Bill may be sold from 18 years to 17 years; enable contraceptives to be sold to persons aged 17 years or under who are married or in respect of whom a prescription has been issued by a doctor, that is a single person under the age of 17 years and increase the outlets through which condoms may be sold, that is from the traditional outlets, such as pharmacies and family planning clinics, under the 1979 and 1985 Acts, to all retail outlets, except through the outlets excluded as mentioned in section 4 (1) (b) of the Bill. The Bill also removes the requirement whereby prescriptions were required for other contraceptives for persons over the age of 18 years by restricting this requirement to persons aged under 17 years and who are single; the requirement whereby registered medical practitioners had to indicate on prescriptions that the prescriptions are for family planning or medical reasons; the anomaly whereby pharmacies which were limited companies were legally prohibited from selling contraceptives and the requirements for importers and manufacturers of condoms to hold licences.
I regard this Bill, a Cheann Comhairle, as a further, integral development of public health policy, with particular reference to containing the spread of the HIV virus. I am pleased, therefore, to be in a position, as Minister of State at the Department of Health, to join with my colleague, Deputy O'Connell, in strongly commending this Bill to the House.
It is time the State was finally and unceremoniously evicted from the bedroom. Unfortunately, this Bill does not do that. Having waited almost 12 months for its publication and having listened with great expectation to the promises of three successive Ministers for Health, especially the present occupant of that office, the reaction to the Health (Family Planning) (Amendment) Bill, 1992, has to be one of utter disappointment.
The Bill does represent some advance on that produced last year by the former Minister for Health, Deputy O'Hanlon, but simply does not provide an adequate framework for a comprehensive family planning service, nor does it adequately equip Irish society for the battle against AIDS. This is the third family planning Bill within a period of 13 years and it is the third botched attempt. Important issues have been ignored and fundamental questions dodged. It is, as I described it on the day of its publication, a typical Fianna Fáil fudge.
There has been a major change in the situation since the Dáil discussed the last Bill in 1985. In 1985 the Bill was judged solely on its merits as a family planning measure. AIDS was then regarded as just some obscure condition which was a health risk for some members of the gay community in the United States. How the situation has changed in just seven years. We now know that AIDS poses a threat to many people all over the world. The World Health Organisation now has more than 500,000 reported cases of AIDS. In Ireland over 1,200 people have been tested positive for HIV — the virus which causes AIDS — but many people believe that the actual number of those with HIV could be three or four times that number. Over 100 people have died of AIDS in Ireland and there is now a death every second week. We ignore the spread of AIDS at our peril.
This Bill has to be judged, then, not simply as a family planning measure but as an anti-AIDS measure. It fails on both counts. It is not a family planning Bill. It deals primarily with the sale of condoms and it would be much more honest if it were to be entitled the Sale of Condoms (Amendment) Bill. It fails to take all available steps to counter AIDS.
Fianna Fáil have demonstrated once again their political cowardice and innate conservatism in the area of social reform. For the past 20 years the Minister, Deputy O'Connell, has been telling anyone who was prepared to listen what a wonderful Minister for Health he would make, how he would be prepared to make decisions on the basis of medical needs alone and how he would stand up to the Roman Catholic Church and other conservative elements. The Minister has fallen at the first fence. This Bill is based on political expediency, rather than on the health needs of a modern society and is, I suspect, responding more to internal Cabinet politics than to the question of public opposition that he has indicated may exist.
The Minister admitted that he would have liked to have made condoms available through vending machines but that he backed down in the face of lobbying from conservative elements. If the Government are prepared to surrender to lobbying on the relatively simple issue of the sale of condoms, what chance is there of their resisting the far more intense lobbying they are likely to face on the much more complex issue of travel and information in relation to abortion?
The Minister made an extraordinary statement this morning at the close of his contribution when he admitted he had caved in to lobbying from a minority group and said: "We are here to defend minorities". We are, of course, here to defend the rights of minorities, we are also here to defend the rights of every citizen.
And to protect them.
We cannot allow a small group of people or even a majority of people in society to deprive others of their rights, their right to family planning, their right to avoid pregnancy, their right of access to information, their right to travel. Not to allow that is the real defence of rights, and simply caving in to those who are attempting to impose their fundamentalist views on society in general is not defending anybody's rights.
One must ask where are the Progressive Democrat Ministers. Where were they when the Cabinet were agreeing to yet another Irish solution to an Irish problem?
The Bill does represent some advance on the current situation but the decision to impose unenforceable marriage conditions and age limits and to prohibit sales from vending machines greatly diminishes its value. There is now widespread recognition among the medical community of the need for the wider availability of condoms, especially in the light of their value in the battle against AIDS. Responsible bodies like the Irish Medical Organisation have urged that condoms should be made available for all irrespective of age. The World Health Organisation has said and the Paris Centre for AIDS Research emphasise that condoms when used properly can block the transmission of the AIDS condition. According to the outgoing head of this country's national AIDS programme, Dr. James Walsh, there is no argument on that in medical and scientific circles. All of the data and the research in western Europe indicate that the condom is 90 per cent effective in preventing the spread of the disease. Even with the enactment of this Bill we will still be one of the few countries which place restrictions on access to a simple device which can prevent unwanted pregnancies and the needless deaths of people from AIDS.
The suggestion from the Minister that pubs and clubs will be free to sell condoms across the counter is unreal. It is unlikely that staff will want to sell condoms and even less likely that customers will be prepared to publicly buy them in crowded bars and clubs. It is medically reckless to prohibit vending machine sales of condoms in pubs and clubs. People are entitled to privacy in regard to their sexual lives and vending machines offer the prospect of confidentiality and safe sex. Condoms are widely available from vending machines in pubs and clubs in Northern Ireland. Yet there is nothing whatsoever to suggest that this has made the people of Northern Ireland any less moral in relation to sexual matters.
Similarly, the Minister must know that an age limit is virtually impossible to enforce. We all know how relatively simple it is for under age people to buy drink and cigarettes. We all know how difficult it is for publicans who want to observe the law to implement the age limit. How can you tell how old a young person is? We have all seen signs in pubs which publicans have put up to try to protect themselves and which say, "persons under 21 not served". Will we now see pubs and shops with signs up saying "condoms not sold to persons under 21"; or will publicans and shopkeepers be reduced to asking young people wanting to buy condoms to produce ID cards complete with photographs and addresses to verify their age and their marital status? This provision is a nonsense. It is bringing in a law that cannot be enforced and enacting such measures simply makes an even bigger ass of the law. The fact that it will be illegal to supply condoms to those under 17 who are not married will not stop young couples from having sex. Making condoms available without an age limit just might encourage them to have safe and responsible sex.
One of the most disappointing aspects of the Bill is its failure to move any nearer to a comprehensive national family planning service. As a medical doctor the Minister must know the impact that unplanned pregnancies have on the health of a mother. One of the most serious shortcomings of the existing legislation — and this Bill does nothing to rectify it — is that it discriminates against all forms of contraception other than the so-called natural family planning measures which are considered acceptable by the Roman Catholic Church. The Minister is required, under Deputy Haughey's 1979 Act, to provide a comprehensive natural family planning service. There is no obligation on him to provide any other sort of family planning service. The result is that the health boards play little or no role in the provision of the sort of family planning service which most couples want and there is no assistance from the Department of Health to those groups, like the Irish Family Planning Association, to provide such a service.
We have long argued for a comprehensive approach to family planning and that it should be provided as an integral part of our overall health system. This view is based on our belief that it is a fundamental personal right to plan the number and spacing of one's children, and, secondly, that it is an important dimension of preventative health care. In some countries, particularly in the Third World, concern about the long term implications of rapid growth in population is the primary argument for family planning but in this country recognition of the right of a woman to control her fertility, together with concern for the personal health of women and their families, must be the factors which are taken into account when deciding on policy in this area.
Let us take a look at the health risks which can arise for women who bear children either very early or very late in their reproductive lives. A study of infant deaths in the United States a few years back showed that 26 out of 1,000 children born to mothers under 26 died in the first year of their lives compared to 15 per 1,000 to mothers in their late twenties. On the other hand, the risk to mothers over 40 of bearing a child with Down's Syndrome can be as high as 14 per 1,000 compared to near zero in younger mothers. The number of children a woman bears in her life affects her health and her family's health. Her first birth carries a slightly higher risk of complications and death for her child than later babies do, primarily because the first birth reveals any physical or genetic abnormality in the mother or father. With the fourth birth the incidence of maternal deaths, stillbirths and infant and even child mortality begin to rise. Clearly then general health would improve markedly if comprehensive family measures were more widely available and were more widely used to reduce early and late pregnancies, to enable couples have only the number of children they want and to give a healthy interval between births.
What we need is not just a Bill to provide easier sale of condoms but to provide for a comprehensive family planning service as part of our overall public health service. It should provide not just for contraception but for related issues such as vasectomies, tubal ligations, breast examination, cervical smear tests, menopausal and sexual counselling. The legislation as it stands makes it possible, but still quite difficult, for women to have access to proper family planning services. It is particularly inadequate for those who are dependent on the public health service and for those who live outside the major urban areas. Access to tubal ligation — female sterilisation — is a case in point. There are some women for whom tubal ligation is the only safe and effective form of contraception. These are typically women in their thirties who have completed their families and for whom other forms of contraception are not suitable. There is no difficulty if one has the money, but successive Ministers for Health have not recognised the importance of this facility. There should be at least one centre in each health board area offering this service free to medical card holders or to those entitled to free hospital services specifically for the purpose of family planning and not just on the basis of other medical grounds.
Why is there not more of an effort by the health authorities here to promote vasectomies among men? Family planning is not just the responsibility of women. Men must play their part. Again, for those couples who have completed their families, male vasectomies can be an ideal solution but they can be relatively expensive for those on low incomes and are not available in all parts of the country. There are still areas around the country where doctors are unsympathetic or not fully trained in family planning issues or where pharmacists simply refuse to stock a range of contraceptives. The problems faced by women of child bearing age in such areas of the country will not be greatly helped by this Bill.
Is it not time we set about removing some of the ludicrous anomalies that remain in our family planning legislation? The provision which prohibits advertisements relating to sexual diseases is just one example. Indeed the advertisment campaign against AIDS on the part of the Department of Health may well have been illegal under current legislation, defined under the Act of 1979 introduced by the Minister for Health, Deputy Haughey. Clearly that legislation not only prevents any publicity campaign aimed at alerting the public to the dangers of sexually-transmitted diseases such as syphilis or gonorrhoea but could be used also to block advertisements on the dangers of AIDS as it can arise from sexual intercourse. Surely it is time we set about removing such Victorian nonsense from the Statute Book? Surely it is time that we unceremoniously evicted the State once and for all from the bedroom by providing not for the control of the distribution of condoms but by ensuring their equality and providing a comprehensive service to our health boards for all our men and women.
My party will not be opposing this Bill on Second Stage. However, we hope the Minister will accept reasonable amendments from the Opposition to render it more effective.
The Bill before us has been long overdue. Indeed, its introduction has been a response to a changing society, an acceptance of the reality today, which is that people are engaging in sexual activity at an earlier age than ever before.
When the Government first indicated that they intended amending the Health (Family Planning) Acts there was tremendous uproar in various quarters. The Government were accused of promoting sex outside of marriage and of encouraging young people to engage in sexual activity.
I was delighted to note that, when the present Minister for Health brought forward his new proposals last week, they led to a much more mature debate and realistic assessment of the position obtaining. Perhaps it is a sign that things are improving in Ireland, which I hope will continue.
Those accusations against the Government were simply not correct or justified. If we were never to amend the Health (Family Planning) Acts young people would continue to engage in sex. If some people choose to bury their heads in the sand then it is the duty of Government to act responsibility. It is my belief that the Government have behaved in a responsible, mature manner in introducing this Bill. In his introductory remarks the Minister outlined his reasons for introducing this Bill and emphasised the necessity to prevent the spread of AIDS. I am sure all Members would agree with me that, from the day he was appointed, the present Minister put on record that one of his priorities was the fight against AIDS. I have no doubt about his sincerity in endeavouring to tackle this enormous problem. However, we must all accept that it is simply not sufficient to make condoms more freely available; educational initiatives are vital if we are to tackle that problem.
There has been much play recently about citizens' rights when, unfortunately, responsibilities are often forgotten. It is vital that schools nationwide educate their pupils about sex. For far too long we have been reluctant to talk about sex in an open, frank manner; it has suited many people to sweep the subject under the carpet. I have no doubt but that attitudes are changing, that, as a nation, we have matured but we still have quite a distance to go. A proper educational initiative would teach those who choose to engage in casual sex to take necessary precautions and act in a responsible manner. It is the duty of Government to ensure that condoms are freely available to such people regardless of how we might regard their behaviour.
Shortly after my election to this House in June 1989 I was asked to give an interview on my local radio — CKR — with Chris Walsh who asked what was my opinion on the position obtaining with regard to condoms. I said then I felt the law was inadequate in that respect, that changes were necessary, that condoms should be more freely available and that I would be in favour of reducing the age at which they can be purchased at 16. I have heard and read much comment over the past three years but nothing I have heard or read has given me reason to change my mind. Three years ago I felt legislative changes were necessary; I contend they are even more necessary today. For that reason I am happy that the Minister has taken the bull by the horns and decided to tackle the problem.
I should like to deal now with two issues, first, the increase in the range of outlets permitted to sell condoms and the reduction in the age at which they can be purchased from 18 to 17. It was crucial to increase the range of outlets since a totally unrealistic position obtained here which meant that condoms were available almost only in chemist shops. The fact that some owners chose not to sell them meant that in some towns nationwide they were not available and could not be purchased. With the proposed increase in the number of outlets henceforth at least all towns, if not all villages, will be treated equally.
As far as I am concerned the purchase of condoms is a private matter. There should be no necessity for half a shop to know when a person is buying a packet of condoms. Citizens are entitled to privacy. For that reason it is essential that vending machines be allowed. Surely the most sensible approach to adopt would be to have vending machines installed in pubs and clubs nationwide? We appear to have serious hang-ups about vending machines; I am not sure why. For example, do we think that a condom purchased over a counter is safer or cleaner than one purchased from a vending machine? I have to say I have my doubts.
As I said, we in Ireland have been reluctant to talk about matters relating to sex. Times are changing, we have matured somewhat but, if we ignore the necessity for installing vending machines in various venues, we shall not have matured as much as I would have liked. A number of Members referred to vending machines and the necessity for their installation. On the one hand I appreciate the Minister's position in that he does not want to be seen to be promoting casual sex or encouraging younger people to become involved in sexual relations. Nonetheless we must accept the reality of the position. In dealing with the reality there is one approach only which can be adopted, that is to install vending machines.
Deputy De Rossa contended it was almost impossible to enforce the 17 year-old age limit vis-à-vis availability or purchase of condoms. When one considers that one can marry at 16 but cannot buy a condom until a year later one becomes even more aware of the ridiculous position obtaining. I would ask the Minister to take a fresh look at that matter now that he has decided to make changes for which I am grateful. Nonetheless there are a couple of amendments necessary to render the provisions of this Bill more realistic in meeting the needs of present-day Ireland.
While in all honesty I cannot say I welcome the contents of the Bill, I welcome the debate it has generated. In considering Members' contributions on Second Stage it would be my hope that the Minister would seriously consider accepting amendments tabled later, particularly since he has made great play of the fact that he had to listen to the views of all his party colleagues on all of the issues involved. It would be my hope that he would take on board also the views expressed by his party colleague, Deputy Power, this morning with regard, not to availability but accessibility, of condoms, in particular in relation to vending machines. I suspect that Deputy Power's views concur with the Minister's personal views. I would go further and say I would suspect there is broad support for that move even among his Fianna Fáil back benchers.
The Bill is symptomatic of the moral cowardice, the sort of creeping paralysis that grips this Chamber on any occasion we discuss questions of private morality. This Bill has had a long gestation period; the original Bill was published by the Minister's predecessor. In spite of this, no significant improvements have been made in the Bill in respect of the people for whom it is designed to benefit. This is very regrettable.
There has been much debate, political and otherwise, about the contents of the Bill. I accept that there are deeply and sincerely held views by people on both sides of the debate and it is imperative that we all put down markers. No one who contributes to the debate can make the use of condoms compulsory or mandatory. That is a question of personal choice and sexual morality. This is safety net legislation; people who engage in sexual activities should have access to contraception. Even though the legislation may cater for only a minority of people, the moral majority have no right to hijack it, which it would seem from its contents they have been successful in doing to date. I hope the Minister will accept the views put forward by Deputies in this debate through amendments on Committee Stage.
Education is a key element in this entire issue. It is regrettable that the Ministers for Health and Education have been unable to date to formulate a proper sex education programme for all students in primary and secondary schools. Some pilot projects have been put in place and aborted attempts made to tackle this issue, yet there is no proper sex education programme in the education curriculum. This is extremely regrettable. It is understandable to a certain extent why some members of the public believe what we are engaged in here today — this perception is latched onto to a large extent by the moral majority or the guardians of our morality — is a preoccupation with condoms without considering the broader issues involved. As I said, education is a key element in this entire issue. This House stands properly indicted for failing to present a balanced approach to this debate. In his opening remarks the Minister heralded this as public health issue. I do not think the contents of the Bill live up to that statement. There is an obligation on us to legislate for the reality which confronts us and not for how we wish things were. The Bill is seriously flawed in this respect.
I wish to refer to the proposed age limit. Why is the Minister apparently prepared to sacrifice the health of people under the age of 17 years who engage in sexual intercourse? There are two possible answers to this question: first, the Minister believes that no one under the age of 17 years engages in sexual intercourse or, second, he is prepared to sacrifice their health by not making available to them, through the strictures of this Bill, access to contraceptives. The Minister has failed to address this very fundamental issue in his comments on the Bill to date. As we know from other legislation, it is almost impossible to enforce age limits. One has only to look at the level of alcohol abuse and under age drinking to realise this. This legislation will be starting off on a wrong foot, so to speak, if the Minister includes provisions in it which are unenforceable, or to which he expects the State authorities to turn a blind eye. This is an extremely poor reflection on the Minister, and I hope he will take on board the amendments tabled in this respect.
As I said in my opening remarks, accessibility and not availability is the critical issue in this debate. Even though condoms are available at present they are not accessible to many people. Condoms are available from chemists, health boards and general practitioners. However, many people find it very intimidating to walk into their local chemist or GP and ask for a packet of condoms. This is the reason many people have sexual intercourse without using contraception. This anomaly has not been addressed in the Bill.
The familiar call in public houses of "two pints of Guinness and a packet of crisps" will not be replaced with "two pints of Guinness and a packet of condoms". This is a particularly sensitive issue in rural areas. It might be possible, with some stretch of the imagination, for people in larger urban centres to go into a public house or supermarket and ask for a packet of condoms but people in rural Ireland will certainly not do this. Every Deputy will bring a particular perspective into this debate, and I know that this perspective will be widely held by Deputies from rural Ireland. People of all ages in rural Ireland are not a whole lot different from their urban counterparts in terms of sexual activities but they will be inhibited from walking into their local supermarket or public house and asking for a packet of condoms.
The Minister should take on board the points made by Deputy Seán Power about the use of vending machines. Anonymity is a critical issue in this whole debate; people are entitled to privacy in terms of their sexual activity. If this legislation is enacted in its present form, people who ask their local barman for a packet of condoms will have to endure the nudge and wink syndrome. This is unfair; it is an intrusion by this House into people's private morality, something we have no right to do.
I hope the Minister will take on board the strongly held views which have been expressed by Members on all sides of the House in regard to the two critical issues of the age limit and vending machines: there should be anonymity in regard to accessibility to condoms and there should be no age restrictions. This House should not be prepared to sacrifice the lives of those people under 17 years of age who engage in sexual activities. We are obliged to provide every possible protection for them. This is not to say that the House condones people under 17 years of age engaging in sexual activities. This goes back to my earlier point about the need for a proper sex education programme in our schools. The ethos of most people would be chastity outside marriage and fidelity within marriage. This is an admirable ethos and one with which this House should be associated. However, we cannot legislate for this and we have to recognise that people under 17 years of age engage in sexual intercourse. These people should have access to contraception.
I welcome the opportunity to contribute to this debate. I congratulate the Minister on introducing worthwhile changes to the Bill. It is important to stress that under this Bill contraceptives will be available in all retail outlets, for example, supermarkets, barber shops, which were popular outlets in Britain for many years and all retail outlets. I understand at present about 40 per cent of chemist shops are refusing to sell contraceptives and that this is creating problems. The minimum legal age of marriage here is 16. Anyone who is married at 16, and not many peope get married at that age, will have no difficulty in obtaining contraceptives. There is nothing in the Bill that outlaws the use of condoms by those under 17 years or suggests they are committing an illegal act if they use them.
Stand by them.
There are people who are deeply concerned about youngsters under 16 years and the State recognises that people under that age are old enough to engage in sexual activity. In a sense that almost gives them the nod, the go ahead. That must be weighed up against the danger of those young people being infected by carriers of sexually transmitted diseases including HIV-AIDS. We have a responsibility to protect our young people in that regard. However, the problem is that very young people who are 11, 12 or 13 years of age are sexually active. In our city there are young people of 13 years of age who brag to each other "how is your kid". That culture exists. The problem is that in many cases those young people do not use contraceptives. In Britain where contraceptives are freely available, and have been for many years through vending machines and other outlets, there is still a dreadful problem.
It is worrying to contemplate the number of people who are HIV positive; 1,250 people have tested HIV positive but we all know the real problem is that the number of people who may be HIV positive and who have not come forward for testing is far greater. It is a frightening prospect that people who may be carrying the HIV virus are afraid to be tested. That is where we should direct our attention and we should encourage people who have any doubts that they may have the HIV virus to be tested. They may infect others with the virus without being aware that they are carrying it and they will never forgive themselves if they discover some considerable time later, having had many partners, that they are HIV positive. That is a problem we should address.
We must also respect those people who have reservations about the availability of contraceptives, they are not all fundamentalists. There is an attempt to dismiss anyone who has reservations about the broad availability of contraceptives as being a fundamentalist. Many people are concerned that peer pressure may be brought to bear on their children; they may be asked, "do you have contraceptives, are you using them or are you engaging in sexual activity"? From that point of view there is a possibility that people under 17 years of age may be subject to this peer pressure. There are many areas to cover, I do not know how much of the legislation is subject to regulation, but a considerable amount of it can be amended. We have come a long way since the first family planning Act was passed and the former Taoiseach, Mr. Liam Cosgrave, walked through the "Níl" while his Government Members voted "Tá".
Deputy O'Malley walked the other way.
The former Ministers, Mr. Paddy Cooney, who is now the great liberal and Mr. Dick Burke, voted against their own leader. We have come a long way and we should not be political. We should all work together, listen, be tolerant, and realise that others have a point of view. We should act in the best interests of the people, and that is what this Bill proposes. If the Bill is not comprehensive enough, the next stage may be to reduce the age limit. I understand 1,250 people have tested HIV positive over recent years, but we all know the real figure is much greater. We can estimate it at any figure we like because we do not have statistics in this regard.
In Britain where there is free availability of contraceptives enormous problems exit in relation to people who are HIV positive and who do not use contraceptives. Regardless of how many partners a person may have had, they will always remember their first sexual experience and they may make empty promises to their first partner. The spread of AIDS is a real problem and I am glad we are going some way to dealing with it in this Bill. We can all work together on Committee Stage and I know if the Minister is persuaded that the Bill should be amended he will be open to suggestions.
The problem does not lie with the Minister; he is very willing.
I believe the Minister enjoys the full confidence of the entire Fianna Fáil Party.
We do not have to worry about that.
We do not have to worry about our partners in Government. I am not aware that they have any——
Absent friends.
Likewise when they are here, I suppose, it can be said.
They are probably down in Dublin Castle.
The Minister has the confidence of the party behind him. The Minister introduced the Bill at a parliamentary party meeting and there was no opposition to it. I am sure the Minister will introduce any amendments he considers appropriate on Committee Stage. He has always been a very independent-minded man and will act in the correct manner taking all interests into account.
I welcome this Bill. In case my comments are misunderstood, before I deal in detail with the aspects of our family planning legislation on which I wish to concentrate, I want to emphasise that I view seriously the restrictions imposed by our laws over the years in relation to access to contraceptives and the obtaining of information about contraception.
These laws created enormous problems and difficulties for teenagers, men and women, single and married people and, sadly, lacked logic and humanity. Instead of educating people for life and for relationships and ensuring that men and women understood their responsibilities to each other and the consequences of their actions, the Oireactas in years gone by pulled a shamrock curtain around the 26 counties that today form this Republic which was designed to keep people in ignorance and denied basic human and civil rights.
When the law is an ass, adult educated people who have the means to do so find a way around it. Unfortunately, the poor, the young the uneducated and the disadvantaged are usually the ones who suffer as they are unable to do so.
Hence, though information on contraception was restricted, despite then existing legislation, many people found their way around the restrictions. As we entered the late sixties and early seventies they were substantially assisted in doing so by the voluntary family planning clinics that were opened. Women who wished to plan their families and control their fertility obtained the contraceptive pill officially not for "contraceptive purposes" but as a "cycle regulator" so as to comply with the law. Under this legal fiction this State probably had the highest number of women in the world per head of population who appeared to have a medical problem with their menstrual cycle. Condoms were, of course, smuggled in by friends and relations visiting this country or brought in by Irish residents when returning from holidaying abroad. The prohibition on sale of condoms was, of course, got around by the the family planning clinics use of the fiction that they were not selling them but giving them away in return for a donation. When the law is a fool, human ingenuity knows no bounds in circumventing it.
It has always been my belief that people should have the fullest access to information about sexual relations and family planning so that they may behave responsibly and have the means to implement the decisions that they make. I have always viewed the restrictions imposed by legislation enacted by the Free State and maintained in this Republic after the coming into force of the 1937 Constitution as little short of ludicrous. In so far as this Bill removes further restrictions I welcome it. I regret, however, that it still maintains some of the shibboleths and ludicrous restrictions that have been part and parcel of our law for some decades.
Having regard to the legislative history of the Minister for Health and the many speeches he has made in this House in relation to this issue I have no doubt that the Bill is well meant and well intended. It is clear from remarks publicly made by him, even since its publication, that the Bill does not fully reflect the Minister's views, but is a compromise measure imposed upon him by the antiquated views which still prevail in parts of the Fianna Fáil and Progressive Democrat parties and around the Cabinet table. I regret that the Minister has retained in the Bill restrictions concerning the availability of condoms which he does not support and which he knows to be largely unenforceable and ridiculous.
It is in relation to access to condoms, that I wish to address the rest of my remarks. Before I do, however, I want to enter one further caveat, again for fear that what I say may be misinterpreted.
Condoms have particular importance in the area of sexual relations. The overwhelming majority of people who use a condom do so in the course of making love as a responsible decision to ensure that an unwanted pregnancy does not result. That is, of course, the primary function of condoms. Condoms, however, play a secondary role. They provide a barrier to the transmission of sexually transmitted diseases and in the context of the AIDS epidemic, they act as a life saver. I want to fully acknowledge this. In doing so, however, I regret that in much of the public comment made by Government about this Bill and in the comment made in this House by Government members emphasis has been placed largely on the issue of AIDS and not on the simple issue of making condoms available to assist people in exercising responsibility in sexual relations.
Many people outside this House share my view that the approach taken by successive Governments over the years to family planning and to the general availability of condoms is little short of idiosyncratic and ludicrous. Any of those who take the time to read reports of today's debate may have a private giggle at the po-faced speeches made and, that no doubt will continue to be made, by Members of this House. Most people view their sexuality as a matter for their own private concern and do not believe that their actions and their access to condoms should be restrained or controlled by legislation.
I wish to address briefly the history of the manner in which this House has dealt with condoms. I suspect that if a space traveller arrived on this planet and visited this island, without seeing a condom or having one described to him, and merely read the debates that have taken place in this House, he would quickly come to the conclusion that condoms are lethal weapons which obviously pose a serious threat to the wellbeing of the human race. If my space traveller was shown a condom, or if one was simply described I suspect he would look incredulously at the occupants of this island and swiftly re-enter his space capsule to visit a saner place.
The saga starts, of course, with the Health (Family Planning) Act of 1979. Under that Act a condom was fixed firmly in the mind of Government as a lethal weapon. If one resided within the State one could not obtain one except by medical prescription for "bona fide family planning or for adequate medical reasons". The fiction was maintained that single people could not obtain condoms but this, of course, was not true. Any person, according to the Act, could obtain one, not, of course, for the purpose of making love but for "family planning or for adequate medical reasons". This ludicrous restriction was compounded by virtue of the fact that they could only be obtained by way of sale — hence, it became an offence for someone residing in Ireland to give to another person be it a teenager or adult, married or single a condom as a gift or by way of a sample for no charge. This criminal offence, the gift of a condom, is a unique and bizarre Irish input into universal criminal law. I am unaware of any other country which has laws which render it a criminal offence and which make people liable to be sentenced to a term of imprisonment for giving a condom to another as a present.
The 1979 Act provided an exemption for "travellers" so that persons entering the State were free to import as many condoms as they wished provided they were for their own personal use.
I was never able to figure how the medical profession came to terms with the 1979 Act. When a suppliant male attended his local medical practitioner seeking a prescription for condoms, how did the GP determine the number of condoms it was reasonable to prescribe on a weekly or monthly basis? Was this determined by a look into the whites of his eyes or an examination of the shape of his kneecaps? Did some GPs prescribe a particular branded condom or did they, for their favoured patients, prescribe a particularly sensitive one? When customs officials were confronted with a person returning home from abroad with a large number of condoms in their luggage how did they figure whether they were all for personal use or whether some might be given away as gifts? The law was, of course, always a farce and was so viewed by the majority of ordinary decent people with no axe to grind outside this House. If the 1979 Act had been a Hollywood production, in so far as the idiocy of its provisions demanded that there be a sequel, I have no doubt it would have been dubbed "Lethal Weapon I".
The 1985 Act, among much heartrending, became "Lethal Weapon II". A somewhat more successful production, it nevertheless maintained in being in our laws ludicrous and outdated anomalies that defy rational explanation.
Lethal Weapon II allowed persons over 18 years of age to purchase condoms without prescription but continued to require those under 18 who wished to obtain them in Ireland to do so only by way of prescription. I wonder how many doctors since 1985 have written prescriptions for condoms for persons under 18 years? The over 18's who obtained them, of course, still could not officially use a condom for the purpose of making love. They had to be used bona fide for family planning or adequate medical reasons. I suppose it is noteworthy that at no time since 1979 has anyone been prosecuted for the improper use of a condom under the provisions of these two Acts. Legislation, of course, continued to allow persons under 18 years of age as "travellers" to bring into the country as many condoms as they wished for their own personal use and continued to prohibit persons either over or under 18 from obtaining condoms otherwise than by way of purchase. It is still today a criminal offence for any person to give a condom to another person as a gift. I suppose it is a small mercy that to date no additional special Government tax has been imposed on those using them.
Lethal Weapon I confined the sales of condoms to chemist shops. Lethal Weapon II extended to registered family planning clinics the right to sell condoms. We now have Lethal Weapon III — the Health (Family Planning) (Amendment) Bill of 1992 published by the Minister last week. It is being rushed through the Dáil this week by a Government who hope that its speedy passage will avoid public controversy and inhibit the self-appointed moralists from launching an effective political attack on the measure.
The good things about the Bill are that it will allow for a far wider sale of condoms and will no longer confine their sale to chemist shops and family planning clinics. This Bill, however, does not allow condoms to be purchased through vending machines. It remains a criminal offence for someone to be given a condom as a gift rather than pay for it and persons under 17 years of age who wish to obtain them still require a medical prescription. There is nothing in the Bill which prohibits the use by a person over 17 of a condom when having relations with a person under 17 years. A person under 17 who is a traveller can of course continue to bring into this State as many condoms as they wish for personal use.
No doubt, the Minister will say that it is against the law in this country for persons under 17 to engage in sexual intercourse and in that he is right. However, law and social reality in this area, as in so many others, do not coincide. This is clearly seen from the statistics of the number of children conceived by teenage girls under 17 years of age over the last ten years. In the period 1981 to 1990, inclusive, a total of 5,518, over 550 each year have been born to mothers 17 years of age and under, outside marriage. If young people are engaging in sexual relations, it makes a lot of sense for there to be easy access to condoms.
As the Minister knows, the age prohibition is unworkable. If the Minister recognises this why is he including it in the Bill in the first place?
This age limit should be removed and should not be preserved in the Bill as a gesture to the self-appointed, self-righteous pressure groups who seem to get sadistic pleasure in engaging in activities intended to strike fear into the hearts of politicians.
I find the issue of vending machines far more curious. If virtually all retail outlets are now to be allowed to sell condoms, why should there be a prohibition on the purchase of a condom from a vending machine? Many people, particularly young people, find it embarrassing purchasing condoms and regard vending machines as a simple means of obtaining them without being caused embarrassment. Vending machines are used worldwide for the sale and distribution of condoms. Do this Government think that the sight of condoms on sale in vending machines is going to result in young teenagers engaging in some sort of national sexual rampage? What public danger is posed by their presence in such machines and by their sale in this way? The Minister's prohibition on the sale of condoms through vending machines is part and parcel of the philosophy that sees them as `lethal weapons.' This foolish prohibition means that this Bill is yet another sequel to a long-running saga which will require further legislation.
The ban on the sale of condoms from vending machines needs to be put in context. Cigarettes are widely available for sale through vending machines and have been for decades. The most lethal weapon a young person can purchase at a vending machine is a cigarette. Teenagers and younger children smoking cigarettes develop an addiction which in this country annually causes hundreds of deaths through lung cancer and which internationally is responsible for millions of deaths every year. If we are to ban vending machines as retail outlets, a ban should be imposed on the sale of cigarettes through vending machines. I do not know of a single death that has resulted anywhere to any person as a result of the purchase of a condom through a vending machine. A Government that regard the sale of cigarettes through vending machines as acceptable are making an ass of the law and bringing it into disrepute if they prohibit the sale of condoms in the same way. A packet of cigarettes is lethal and can kill. A packet of condoms can ensure responsibility in sexual relations and may save a life.
It is time, Sir, for us to move away from the use of euphemisms. The contraceptive pill may be useful as a cycle regulator but it is used by most people to enable them to make love responsibly. A condom may be a protector against the transmission of sexually transmitted diseases but it is also used primarily to enable people to make love responsibly. It is a pity, Sir, that in the context of this Bill nothing has been said by the Government about the benefits of making love in a responsible way within a close loving relationship. It is a pity that this Bill fails to fully confront and recognise this aspect of human relationships. As a political climax to the political year it is sadly uninspiring. As an example of open Government and a willingness to implement radical social reform this Bill has unfortunately failed the test. It is, however, not too late for the Minister to agree to the amendments necessary to bring this long drawn out and bizarre legislative saga to a satisfactory end.
I will be brief because I am aware that many other Members wish to contribute to this debate. First, I congratulate the Minister on his appointment and wish him every success in the future. He has been a very positive and active Minister.
In his opening address the Minister said that this legislation was required urgently for two reasons: first, and most importantly, for public health reasons and, second, to bring our family planning legislation more in line with public mores and thinking. I support the introduction of this legislation on the grounds of public health. The Fianna Fáil parliamentary party have given their support to the Minister's Bill. A certain amount of public controversy was generated by the proposal to amend the legislation to make condoms available to those of 16 years and over. However, in this Bill the Minister has struck a fair balance by making provision to make condoms available to those of 17 years and over, thus reducing the present age limit from 18 to 17 years.
The only reason I would not object to the provisions in this Bill is on medical grounds. The medical profession indicate that there has been a vast increase in the incidence of AIDS. A recent report from the Eastern Health Board indicated that in the last decade of the 20th century the greatest potential public health threat facing Ireland is AIDS. Since AIDS was first diagnosed in Ireland in 1982 there has been a steady increase in the number of cases and resultant deaths from AIDS. A national AIDS strategy group were established at the end of 1991 and they have recently reported to the Government. The medical profession have also expressed their concern about the increasing incidence of AIDS and have advised that condoms should be used as part of our strategy to prevent the spread of AIDS.
This Bill makes provision for increasing the number of outlets where condoms may be purchased but there is no provision to make condoms available through vending machines in public houses. The purpose of the Bill is to make condoms available to persons who have reached the age of 17 years and over in order to reduce the risk of contracting AIDS. RTE interviewed people on the street and the view expressed was that people would be reluctant to approach a staff member in a public house in order to purchase a packet of condoms — indeed, can you imagine asking somebody for a packet of condoms with his pint?
What about asking for a loaf of bread and a packet of condoms?
Those interviewed expressed the view that, if condoms were available from vending machines in the toilets of public houses, they could be acquired without embarrassment. I believe the Minister should consider these views — indeed, that very point was made by some Deputies in the House. Under the licensing laws people in public houses must be 18 years or over and therefore if condoms were available in public houses we would not be breaking the law. If we are to achieve what the Bill sets out to do it would be helpful if those who were sexually active used condoms. I would be completely opposed to making condoms available through vending machines in places where discos are held. As I stated at the outset, the only reason I support the Bill is on health grounds and we should not be seen to be encouraging young people to become sexually active. I am aware, however, that pressure is being put on the Minister and the Government to introduce this Bill. May I compliment the Minister once again and wish the Bill a speedy passage through both Houses of the Oireachtas?
At the outset may I state that it is time for us, the legislators, to firmly and unequivocally state that we are here to make laws that will be viable, practical and of positive assistance to those whom we represent? I intend to be very brief. Having listened to previous speakers, I recall those early days in 1973 when I began my political career in Seanad Éireann. In 1972 the distinguished person who will visit this House later today had proposed the introduction of the first family planning Bill in an atmosphere in which the Bill itself could not be put into print — there was opposition to the printing of any such Bill. During the second attempt to introduce a family planning Bill there was what could only be described as a disgraceful campaign against those who were trying to suggest introducing the basic elements of family planning legislation.
Now is a time to be generous and to positively acclaim the changes in public attitude, including the rather more tardy change in the attitudes of legislators which has taken place in the intervening period. It is tragic that we cannot discuss and initiate this legislation on grounds that are drawn firmly from social policy and public health and from the perspective of rights. People who engage in sexual activity are engaging in an act that is protected in most law by legislation governing forms of privacy. Indeed, this was one of the principles invoked to enable the use of certain forms of family planning within marriage in the early legal cases. There is also a matter of social and public policy and a recognition of the kind of society in which we live. In the early years people drew from a set of prescripts that claimed a transcendent authority. I remember a very honest speech by Senator Michael J. O'Higgins in which he quoted the prayer we say in the Dáil and Seanad at the start of business and he suggested this was a vindication of natural law which took precedence over all positive law and certainly over the law of the State. His was an honest speech but there were many other dishonest speeches over the years in which people sought to whip up irrational and prejudiced fears against those who were seeking to change the direction of necessary legislation. I have always paid tribute to his speech because I believe that he genuinely believed what he said, which was in stark contrast to those who were exploiting and degrading themselves and the legislative process by whipping up emotional and unsustainable fears.
One could hardly say that in this legislation we have made the leap to being able to respect conscience, defined broadly, within the rights of the State that stands separate from any particular denominational prescription. It is indeed the incredible shadow of AIDS that stands behind the present legislation. One must ask whether it says something about a Legislature and its response to the needs of its society if it is necessary to have such an incredible and dreadful disease threatening society before that Legislature is forced to act. As I try to answer that rhetorical question to myself, I have to conclude that we are not yet in the realm of legislating socially and responsibily in terms of public health.
How can it be that at the end of this century a vending machine is becoming an object of idealogical significance to speakers to whom I have listened from my office today? Do people really think that there are those who nowadays when they go into places of public entertainment, places where people who are sexually active are gathered, and do not see a vending machine will congratulate themselves and think of that as a great ideological victory on their part in that they stopped the installation of any vending machine at that place? And will they know at the same time that those who are sexually active and who could with discretion procure condoms will be prevented from doing so, and by being prevented from doing so acquire a much greater risk than they need be asked to carry? It simply does not make sense to be holding this point. A very thin body of research in relation to people who acquire condoms has been carried out, but it does exist. After all, many people in society remember the trauma following the mention of terms such as "life skills", and there are groups in this country that would like life skills to be taught without any reference to biology — another unique feature of our culture.
Without adequate education and public information a great series of inhibitions is placed on the sexually active person and the ability to acquire condoms if he or she wants to have sexual relations in a responsible manner. Surely it would be much easier for people to overcome all of those obstacles by being able to acquire condoms from a vending machine. I do not recognise any way in which it could be progressive to put this blemish on this modestly amending legislation.
What about the requirement for an age limit in relation to the purchase of condoms? What earth-shaking research is available to the Government but has been hidden from the rest of the world that suggests that people become sexually active at the age of 17 and do not need protection for safe sexual relations before the age of 17? I am reminded of the old arguments about the miraculous concurrence of the age of seven and the age of reason, which declared that on one's seventh birthday there was some kind of cosmic shift in one's consciousness. That kind of antiquated nonsense is being smuggled into the Bill. Who could implement an age limit of 17? Are we following down the road that led to the phrase in the intoxicating liquor legislation, "knowingly serve"? Could one knowlingly deliver a condom to a person one genuinely thought was 17? If one were to follow the logic that appears to have informed the legislation, which is to make a response late in the day to the phenomenon of AIDS, surely one would not only be talking about availability in the best circumstances in which one would impact on that but would also be trying to use a term of definition of access that would not include an age restriction of 17.
Another question relates to the notion of the prohibition on advertising. If the legislation accepts the enormous import of the AIDS problem and the need to act responsibly, is it not rather daft not to amend those antiquated laws that place restrictions on advertising?
I pay tribute to organisations such as Condom Sense, which are supported by distinguished people who are seriously concerned and who have taken great risks, both professionally and otherwise, in supporting the availability of condoms. I know one of the founders of AIDS Help West. That person spoke to me about this legislation and expressed a strong feeling that there is need for amendment. I know that the Minister for Health is very informed about what happens on the ground. I say to him that on this occasion, it is a case, if he wants to be courageous, of responding to the public need rather than to any irredentist elements that have personal hang-ups about vending machines or the true age of people or that feel suddenly frozen on the sight of a newspaper advertisement for condoms. From such people may we be released, in a secular, liberal and democratic sense, before we all die. May the Minister release himself before this legislation is enacted. I suggest to the Minister that people who imagine that their pints will get flak if there is a condom machine within the environs of a pub, or that the bread will go off quickly or that the milk will curdle if there is a vending machine within hundreds of yards, are not in the real world. It would be fine if those people wanted to live in the world of their personal eccentricities, but we are not talking about that.
I remind the House that we are legislators and what is required now is good and adequate legislation. I strongly implore the Minister to listen to those organisations that have said to him that if the legislation is to be effective he should consider amendments in relation to the age limit, vending machines and advertising. I also suggest that he has a great opportunity because perhaps — and this point has been made by my colleague, Deputy Howlin — he is now in an atmosphere in which he is likely to be able to carry the support of the House, support from all parties, in making the legislation effective. He will be able to deliver the legislation as an instrument which will have an impact on a grave social and health problem. The Minister will be remembered if he does that but he will not be thanked if he allows the coming into effect of the needless restrictions contained in this legislation at present.
It is a very sad reflection on the state of our legislation and on the confidence we have in ourselves that we should be able truthfully to describe this Bill as progress. The legislation is progress, but it is a sad reflection of where we are coming from that we can describe a Bill such as this as one that makes a progressive move in our legislation.
During the course of this debate a great deal of emphasis has been placed on the very important public health issues that arise in relation to AIDS and other sexually transmitted diseases. I agree with some of the very wise things that have been said but I should like to go back a little to more fundamental issues. I do not consider that the question of family planning, as we euphemistically call it here, or contraception, as it should more properly be called, is solely or even mainly a public health issue. There is a matter of basic fundamental human rights involved here. Since we are told that the use of reason is what distinguishes humankind from the rest of the animal kingdom we should apply that lesson to all areas of human behaviour. I deliberately say "humankind" and not "mankind" in case I might complicate the issue with another diversion. Although I am sceptical about it from time to time, if it is true that the use of reason is one of the things that distinguishes us, it seems logical from that that humankind has the right to control its fertility and its reproduction, that women most particularly have the right to control fertility, to control reproduction, and that that right should not be interfered with in any way. It is a matter for women of physical, mental and what I might call social health. This is something that should be uppermost in the minds of legislators.
That is not to say the responsibility for the control of fertility and reproduction should rest only with women. Of course it should not, but we are dealing here with an area of legislation which is of importance to all humankind but of particular importance to women. We should not forget that. I see no fundamental reason whatever for the State being involved in legislating for what are called non-medical contraceptives. As I have said, I believe control of fertility and reproduction is a basic human right and I see no reason why the State should interfere in that any more than is absolutely necessary. I accept that there are other forms of contraceptives where the State has a perfect right and, indeed, an obligation to intervene in order to protect public health and most particularly the health of women. I do not need to go into all this area of the contraceptive pill or the various IUDs that have been on the market and that have caused serious problems in recent years. The State has a perfect right and, indeed, an obligation to intervene in those areas to regulate the kinds of products that may be made available in the interests of public health, private health and particularly the health of women, but that issue does not arise in relation to condoms.
There is much nonsensical, quasi psuedo-statistical stuff about condoms. Many of us will have received in our post today a copy of The Condom Bill — All the Facts published by the Children's Protection Society, which sets out to prove that the more you make condoms available the more widespread AIDS will be. It is perfectly possible mathematically to prove there is a statistically significant correlation even at the 95 per cent confidence level between the rate of ownership of microwave ovens and the certainty with which we know the moon is not made of green cheese. You can prove that mathematically and perfectly respectably but the one has nothing to do at all with the other. That is the kind of nonsense these irredentist guardians of our morals, who never consult us about it, try to foist on us in this. There is no reason why the State should intervene in any way in the provision, distribution and sale of non-medical contraceptives. The only obligation the State has is in setting quality standards so that the product, if I may use the term, performs up to specification. That is the only area that is of proper public significance.
I am disappointed with the step the Minister has taken about spermicides and the reasons he gave for it today. It seems absolutely outrageous for the Minister to say he is going to change the way we treat spermicides because he is afraid people will regard them in some way as a prophylactic if he does not control them. That is nonsense. The Minister has taken a totally unnecessary step that will unnecessarily complicate life for people who otherwise might have got a grip of what is involved in various methods of contraception which they might have found could contribute to their lives. Let us make no mistake about it, when we are talking about non-medical contraceptives — my colleague Deputy Shatter spoke of this — we are talking about the most readily available, least complicated and simplest form of contraception. God knows, anybody who is acquainted in any way with social life, particularly social life among lower income groups, will know that the question of contraception or, as we euphemistically call it, the question of family planning, is much more for a great many families and a great many women than this theoretical concept of spacing out their family and deciding whether there will be two, three or four years between the children that will be born to the family. It is a matter of day-to-day concern and a cause of great mental anguish and frequently a cause of severe mental illness to them. Deputy Creed mentioned that the fact that we do not have access to non-medical contraceptives on as wide a basis as we rationally should is directly the cause of a great deal of suffering, mental anguish particularly to women, and a great deal of tension in marriages.
If these moral guardians are as seriously concerned as they claim to be with protecting the institution of marriage and family life, they should be advocating the widest possible availability and the greatest degree of accessibility of non-medical contraceptives rather than advocating the contrary. We know from surveys that have been done, from observation and from work that has been carried out by people involved in this area that access to non-medical contraceptives is in many parts of this country a patchy, hit-and-miss affair. The Minister rightly realises that he cannot oblige anybody to stock condoms. He is hoping, apparently, in this Bill that by making it possible for a wider range of outlets to stock them, somehow something magic is going to happen and they will be made available on a wider basis. I hope I am wrong, but I am prepared to bet that in 12 months' time the 166 Members of this House can walk around their own home towns, home areas or electoral districts and count on the fingers of one hand the number of new outlets where condoms will be available as a result of this. For example, nobody is going to tell me that my local supermarket are suddenly going to move, that my local grocer or greengrocer is suddenly going to have condoms available. The Minister is making sure there are some kind of outlets that will not have them available, because he is prohibiting the use of vending machines. I am prepared to bet that if we come back here in a year's time the Members of this House will be able to say, "I do not know of anything even like five or six new outlets in my area where condoms are now being made available as a result of the legislation passed". If that is the case the Bill will very largely have failed in what it sets out to do and will not have contributed any noticeable increase to the level of human wisdom, human happiness, marital concord or any of the other things this Bill should set out to promote, if indeed, we should have a Bill at all about non-medical contraceptives.
It is a general reflection that in many areas like this, and maybe in relation to the Intoxicating Liquor Act that Deputy Michael D. Higgins spoke about a few moments ago, the more the State intervenes the more the State is going to get it wrong. That is a lesson we should learn from this.
There is one other area on which I want to touch briefly. There has been a great deal of publicity about the question of the reliability of the condom as a contraceptive and a health measure. There has been this nonsensical claim — repeated again today — that in all the countries where condoms are most widely available AIDS is most prevalent, which is true, but the two are totally unrelated. Nobody can claim any statistical basis for saying that, in a specific case, the use of a condom is not a useful means of preventing the transmission of AIDS or other sexually transmitted diseases. There have also been spurious comments about the failure rate of condoms from organisations like the Children's Protection Society who, like the so-called pro-life group in the latest debate, showed no concern for facts, truth, honesty or the use of language. Of course there is a failure rate and failures by the people using condoms to understand how to use them properly. That is something which manufacturers — and the Minister — should try to remedy. Here again, in any situation it is less likely that conception will take place if you use a condom.
I hope in the public debate from here on that we can get past this spurious, quasi-statistical nonsense and go back to the simple proposition which should inspire legislation — or even a lack of legislation — which is that humankind have a right and indeed an obligation, when you look at the pressures in the world, to control fertility and reproduction. The use of non-medical contraceptives is the safest, healthiest and most reliable way of doing this as it respects the integrity of the individual and, specifically, the health of women.
May I share my time with Deputy Fennell?
Is that agreed? Agreed.
It is unfortunate that time is so limited and that so few speakers can make their views known. In particular, it would have been very revealing for the Minister, and his policy makers, to hear views of Members of his party. One or two of them spoke and they generally supported what was said by Opposition speakers.
The two main concerns on this side of the House — which would be shared by all political parties — is that the issues of the availability of condoms through vending machines and the age limit should be addressed. I appeal to the Minister to consider those issues. In recent weeks we had the debate on the Maastricht Treaty which veered on to the abortion road. The people who preached loudly on the issue of abortion and the necessity to change the judgment of the Supreme Court failed to address two very important subjects, namely the question of the thousands of Irish women who travel every year to Britain for an abortion and why they do this. We should reflect on the old saying that prevention is better than cure. Why do we have 4,000 unwanted pregnancies here? One of the main reasons is that our attitude to the availability of condoms is extremely immature and results in a situation where tens of thousands of people practise unprotected sex, resulting in many young girls travelling to Britain for an abortion. If we could, through this legislation, do anything which would stop even one of those girls having an unplanned and unwanted pregnacy we would have done a good day's work. However, the legislation will not be very helpful in that respect.
We must live with the reality that the Ireland of 1992 is very different from the Ireland of 1985 and it is even more different from the Ireland of 1979. Things have changed dramatically since we debated family planning in 1974. We must all accept that the comely maidens and their male equivalents have long since left the village green. We must live in the new Ireland and the new Europe and face up to the fact that people look at lifestyles differently in 1992 compared with some years ago.
Our job is not to legislate for morality, I think it was Deputy Creed who said that we must legislate for reality but we are not going far enough in that respect. We all have certain standards to which we would like people to aspire but that does not always happen. We must try to ensure that the legislation we put in place in relation to family planning will be realistic and meaningful.
Deputy Creed also said that the question of availability of condoms is quite different from the question of their accessibility. I know life in rural villages and towns and, under present legislation and indeed the proposed changes, it would still be extremely difficult for most people to buy condoms in their local village or town. Vending machines are necessary and unless we make provision for them in the legislation we will have made very little progress.
The question of the age limit must also be addressed and changed, as it will be impossible to implement. Condoms will be available to a person aged 17 years and one day while a person two days younger will not have access to them. Who will be the judge and jury in this regard? There is no point in introducing legislation which cannot be implemented.
I deplore the haste with which this legislation is being brought in. It is very difficult for someone like me who has a long term interest in this subject because I had to make my views known in the "letters to the editor" column. The way we organise business in this House is a disgrace. I regret that the five minutes in which I have to speak will be the only contribution from a woman Member. The lack of family planning grievously affects women.
The whole debate is furtive, it is as if we are ashamed of what we are doing here. This is only the third time that family planning has been discussed in this House, in 1979, 1985 and today. Members should think about the message this debate is sending out, it is a message that it is something shameful, which we cannot discuss openly or debate honestly. It is restricted in the most dreadful way. We are in the medieval age with regard to contraception. It is regrettable that the Minister for Health, who I am convinced cares and knows better, has not had the courage and leadership to go all the way and to have a proper debate. We do not need laws, we need to provide information, facilities and to ensure that everyone who is sexually active has a responsible attitude to family planning.
If we are to have a debate it should be an open, honest one. Let us look at the total area of family planning and the needs in relation to it. We should take account of the awful circumstances from January of this year in relation to the High Court and Supreme Court cases on the young woman who was raped and subsequently became pregnant. That is part of this debate and we are very remiss in having such a limited and small section in this Bill and leaving out all the other areas. I should like to have the area of information discussed; the Minister missed a wonderful opportunity to amend the 1979 Act to enable us to have proper information outlets and policies with regard to family planning and, if necessary, abortion referral.
I stress the need to change the whole approach to family planning from the medical approach. Far too many Irish women are on the pill. Many women who would not have access to family planning clinics or to GPs who would have a sympathetic approach to all forms of family planning will tend to take the pill. In many instances this is very bad for them. Problems like varicose veins or other medical conditions may arise. There should be a promotion campaign to inform men and women about the various forms of contraception, where they can get them and what is safe for them. The thrust of the Bill to make condoms more readily available is right but we must go much further. Condoms are readily available and their use does not interfere with a person's physical state. They have been proved to be effective.
I join with other speakers on this side of the House who have condemned the age limit and have suggested that it is ludicrous not to allow condoms to be sold through slot machines. The sky will not fall if we agree to give people freedom of choice by allowing slot machines. We should let individuals make their own decisions. What will happen to the 11 slot machines which are already in position? Are the Garda Síochána to be deployed, when the Bill is passed, to take away these slot machines? That question must be answered, given the explicit condition in the Bill.
I would ask for greater information on the availability of family planning. I have in mind information which would be provided by the Department of Health. I asked some time ago what information is available to people who want to know the various forms of family planning. I was referred by the Department of Health to the Mother and Child Book, a delightful book published for young mothers to tell them about feeding their babies and the first developmental steps. That is an inappropriate response to somebody who inquires about family planning. I would hope that we would reach maturity.
We will not get the chance, during this furtive and hasty debate, to educate and inform people, to tell them that they are perfectly entitled to plan their family and to adopt a responsible approach to sex if they are sexually active, so that children who are not wanted are not conceived and we can reduce the number of women going abroad for abortions and the huge number of children conceived outside marriage, most of whom are not wanted and end up in the deprived zone of society, poor, uneducated and without a proper chance in life.
I would wish for a fuller debate and a more generous and open approach to this legislation. One must welcome it as a means of improving the awful position which exists but it does not go far enough.
I welcome the opportunity of participating in this debate and the recognition of the need for the broader availability of condoms in a range of retail outlets. I do not believe there will be a huge number of retailers indicating a desire to sell condoms. A number of outlets may decide to do so but could find there is not a market for them. In some areas there may be a problem with regard to attitude to over-the-counter sales. This will not work as well in rural society as it may in urban society.
The legislation is progressive in certain areas but I am not wholly satisfied that it goes as far as I would wish. I say that as a young, sexually active person who is also a parent. Some colleagues opposite have indicated that there should not be an age restriction but I cannot agree fully with that view. The Minister has indicated two important elements, the public health aspect and the bringing of family planning legislation more into line with current public thinking.
I am very familiar with problems in relation to sexually transmitted diseases, particularly HIV and AIDS, and the numbers of deaths in this category. The Eastern Health Board figures indicate that there have been 188 deaths from AIDS and 272 cases of AIDS identified. God knows the number of unidentified cases. The cost implications of the development of services to cater for AIDS are mind boggling. It will continue to account for a huge proportion of the health budget for many years to come.
I tabled a question to the Minister for Health concerning the number of single parent births over the past 25 years. I have not the exact figures with me but I recall that in that period the figure rose from about 290 to 7,000. I do not know how many single parent births are unwanted or what effect the greater availability of condoms would have. Condoms have been available through family planning outlets for some time.
The Minister said that it is of paramount importance that the spread of HIV infection is curtailed and he referred to the range of recommendations made by the national AIDS strategy committee towards this end. He said that the recommendations have been accepted by him and are being implemented.
The National AIDS Strategy Committee in their conclusions and recommendations cited eight short-term recommendations and nine longer term recommendations. In the short-term recommendations they state that the legislation should be amended to allow for the sale of condoms from vending machines and for the distribution of free condoms by statutory and voluntary agencies involved in HIV prevention. That is an important recommendation. I am pleased the Minister has indicated that these recommendations have been accepted by him and are being implemented.
I raised this matter in another forum this morning and at a meeting last week at which I strongly supported the recommendation of the National AIDS Strategy Committee regarding vending machines. To avoid being misunderstood in regard to this matter, I want to state clearly that I would not like to see a vending machine in every public toilet or on the corner of every street. That would not be the correct approach. When I raised this matter in the other forum to which I referred, I said that vending machines should be placed in venues where people are more likely to make sexual advances — disco bars, nightclubs and so on — where people of 17 or 18 years of age and over attend. Disco bars and nightclubs usually do not open until midnight or afterwards, or at least people do not frequent them until late at night. I do not envisage people under the age of 17 years being allowed to gain entry to such establishments or using the condom machines that would be provided there. As the Minister has taken on board the recommendations of the National AIDS Strategy Committee will he clarify whether vending machines will be introduced by ministerial order?
In section 4 (1) (b) the Minister prohibits the sale of condoms from vending machines. I welcome the fact that he prohibits their sale at other outlets, but there seems to be a contradiction between the Minister's speech and some sections of the Bill. Therefore, I would welcome clarification on this aspect.
The Minister dealt with the public health issues and strategy in relation to the prevention of the spread of sexually transmitted diseases. It is important to refer to a report circulated by the Eastern Health Board in relation to services for HIV and AIDS patients which stated that, whatever the target population, the core message is the same. HIV is spread by sexual intercourse and the sharing of dirty needles. If we can ensure that the recommendations of the National AIDS Strategy Committee on the free distribution of condoms by statutory and voluntary agencies and the sale of condoms from vending machines are implemented, it would be a step towards meeting that core message that condoms should be made available to help in the prevention and spread of sexually transmitted diseases, in particular HIV, which may lead to AIDS.
I regret that we have very little time to discuss the Bill, but I look forward to the Minister clarifying the points I made and further participation on Committee Stage.
With your permission, Sir, I wish to share my time with Deputy Byrne.
Is that agreed? Agreed.
Like other Deputies, I regret the way this legislation is being handled by the Government. While I recognise that it represents progress, small though it may be, the fact is that we had to wait for more than a year for the original Bill to be withdrawn and this new Bill to be circulated. That reflects the difficulties the Government have in trying to approach this issue within their own ranks. As this Bill is being rushed through the House in a very short Second Stage debate, and an equally short Committee Stage debate, some of the fundamental issues will not be dealt with and will, in fact, be overlooked.
The fundamentals we should lay down are the right, if not the duty, of the Government to provide for proper fertility control, an issue that, unfortunately, was not addressed in any comprehensive way at the recent Earth Summit in Rio de Janeiro. That must be addressed by this Government in the overall context of social planning and direction. The right of individuals to privacy as a paramount concept in regard to regulating and legislating for family planning purposes has been lost. We should respect the right to privacy of people who are past the age of puberty and who wish to engage in free and responsible sex.
Because we have forgotten, if not overlooked these basic rights, the legislation before the House is seriously flawed and disappointing. This is not a family planning Bill, it is incorrectly titled. It includes very narrow proposals in some respects and primarily deals with the availability of condoms. For example, issues relating to the availability of resources to the health authorities to educate people about the responsible use of family planning devices are overlooked in the Bill. In particular, a sectarian provision in section 9 of the 1979 Act should have been deleted. The provision enabling resources to be provided for research into "natural family planning methods", as they are described, is blatant sectarian legislation that should be deleted.
The Bill does not deal with the issue of tubal ligation which has generated controversy recently by the two-handed act of Bishop Casey who did a secret deal behind the backs——
Acting Chairman:
The Deputy should not name people who are not in the House to defend themselves.
He is not in the country.
——of his parishioners with the local hospitals and got guarantees that no such practices would be engaged in by the hospitals in the Galway area while at the same time he publicly expressed concern about Third World development and poverty.
The provisions of the Indecent Advertisements Act, 1889 — section 3 in particular — should have been addressed in this legislation to make it possible for advertisements with regard to family planning, and devices to be used for family planning purposes, not to be the subject of prosecution or restriction in the way provided for under that Victorian legislation. We should not fool ourselves in this regard. I do not want to take away from the arguments the Minister is advancing about the importance of the condom as a device to aid in the campaign against the spread of AIDS. That is an important aspect of the legislation but is not the primary one. The Minister is being a little disingenuous in attempting to float this legislation through for public health reasons only. We recognise that condoms are a useful device in regulating unwanted pregnancies. It is a very good device in the campaign and fight against abortion and the number of women who travel on a daily basis to England to avail of abortion services there. That is the primary reason we are arguing for more availability of condoms. The restriction on the vending machine device should go. Not one Deputy who has contributed, from whatever party, has argued for the restriction to be maintained. I hope the Minister will take that point on board on Committee Stage.
Currently there are vast areas of the country that do not have available to them a simple condom device because chemists, for their own particular reasons, will not sell them. That is their decision. I do not see the climate of that locality changing simply because of this legislation but I do see an opportunity arising where a vending machine becomes, so to speak, part of the furniture of the public house, the dancehall or wherever couples frequent as in Britain and in Northern Ireland. If the Minister is serious about ensuring that condoms have a wide circulation the vending machine is realistically the only vehicle by which to achieve that objective. May I ask for guidance when five minutes remains?
Acting Chairman:
The Deputy has until 2.50 p.m. He has eight minutes left.
I wish to share some of my time with Deputy Byrne. I am concerned about the provisions in the legislation with regard to spermicides and, indeed, the way in which the pill will now become less readily available because of the way in which "contraception" is being redefined. I would ask the Minister to reflect on that point before Committee Stage. We should be arguing for greater availability of these devices, not for their restriction. I do not accept the arguments put forward by the Minister that they have to be differentiated from other non-medical devices. In particular, the provisions with regard to spermicides must be examined.
As someone who was not here to contribute to the earlier debates on previous legislation, I bow to those who were in the House and who like to recall the years 1972 to 1974. As we approach the conclusion of Second Stage we can pat ourselves on the back that this House has taken the opportunity to debate in a cold, cool and logical way very important legislation. I hope that, because of the way the debate has been structured and the responsible way in which Members have contributed, the Minister for Health will take on board the points made by Deputies on all sides of the House with regard to certain provisions in this legislation.
Tomorrow I hope to see substantial amendments being tabled by the Minister to reflect points being expressed, such as the question of the age limit which cannot be policed and is unworkable. Time will not allow us on this side of the House to table all the amendments that need to be tabled to improve this legislation. The onus rests on the Minister, in view of the opinions that have been presented, not only from this side of the House but from within his own party to table such amendments.
I thank Deputy McCartan for allowing me five minutes of his time. I stand here today as the first inner city Deputy to contribute; in fact I share a common constituency with the Minister for Health, Deputy O'Connell. Like me I am sure the Minister is aware of the crisis and the number of families that have been afflicted with HIV and AIDS-related deaths. It is not an exaggeration to say that in Dublin South inner city there is a death per week resulting from AIDS. I am amazed that the Minister, who would be conscious of this fact, being a medical doctor, has put so many restrictions in the Bill. The stark facts are that in Dublin alone — and this is backed up by the report of the national AIDS strategy committee — there are between 2,000 and 7,000 drug abusers. The Minister's statistics showed that 1,250 people have tested HIV positive. What the Minister did not tell the House and what the House should be made fully aware of is that while 1,250 may appear to be a relatively smal proportion of the population, it takes eight to ten years of an incubation period before it can be medically proved that one is HIV positive.
The national rate for live births to unmarried women is 16.5 per cent. In parts of Dublin city, in community care areas, the rate is 20 per cent and in other parts of the city there is an even higher percentage. Drug abuse and sexual activity are rampant. If we look at the statistics for people seeking accommodation from local authorities we see a number of single parents on that list. The Eastern Health Board provide the startling figures relating to the number of births outside marriage. The Bill before us indicates we are washing our hands of the realities of life. The realities of life in Dublin city are frightening. The Minister has an obligation to the House to be brave and tackle these problems with which he has the power to deal. I cannot understand the logic of the Minister's position when he says he is personally in favour of dispensing machines. He argues that he favours reducing the age limit even further or abolishing it altogether. Who is dictating to him? He is the Minister with the power to bring in legislation.
When the Minister was appointed Minister for Health, looking all Members of the House straight in the eye he said he would not allow the Church to dictate anything to him. Who is now dictating that the most convenient method of making condoms available through vending machines should not be permissible? Five minutes is a farcical amount of time in which to endeavour to make the points which need to be made. If there is any time remaining at the end of the Fine Gael contributions perhaps I could be awarded another ten minutes to make a few more points.
I should like to oblige Deputy Byrne if that were possible but I wish to share my time with Deputy Reynolds and we have approximately five minutes each. Lest anything I might say later would be interpreted differently I should say, first, I have no objection to contraceptives being made available to those who wish to use them. It is not the duty of legislators to choose between any set of moral beliefs.
I have serious reservations about the manner in which this debate has developed not merely in the House today. I contend that the public debate over the past 12 months lacked a certain element in that contributors to this debate, especially when speaking to and about young people, should express the view that sexual activity outside of marriage is wrong and should be discouraged. One would glean the impression from the public debate on this issue that sexual activity on the part of young people is something to be encouraged whereas exactly the opposite should be the case. I want to put that clearly on the record.
We are told that young people would be embarrassed purchasing condoms, that they should be available for sale from vending machines. I have no great hangup about that aspect. But do we hear any responsible adult say to young people that they should not engage in sexual activity until they are in a mature, stable relationship? That needs to be said in this debate. The impression being created in the media, probably also unwittingly on the part of some politicians, is that there is something wrong with teenagers who are not sexually active, that they are not normal. That impression should not be created in the course of this debate. There are four teenage children of each sex in our family. My wife and I endeavour to advise our children not to engage in sexual activity. That is a duty and responsibility of all parents. We should not under estimate young people's desire to behave sensibly and responsibly but, for Heaven's sake, let us encourage rather than brainwash them.
I listened to a programme broadcast on RTE 1 on Monday last, "Queuing for a Living", presented by Paddy O'Gorman. He interviewed people who had engaged in petty crime, such as shoplifting, handbag snatching and so on as they left a courtroom. I was amazed at the attitudes of some of the people he interviewed. I asked myself what is wrong with us, as a society, that people should have such attitudes? At the time I was travelling down a busy street in Galway, when immediately my question was answered. I was approaching pedestrian traffic lights. There was a child of about four years of age vigorously pushing the button. I stopped, thinking the child would run across the road but, as soon as the light changed to red, the child continued on the same side of the road. I rolled down the car window and said to the child in a rather stern, but not aggressive manner, "Please do not push the button unless you wish to cross the street." Fifty yards on I was held up at a main junction, by which time the child had caught up with his mother, who seemed to be a respectable, ordinary woman. I saw her approach my car in the side mirror. I assumed she was coming over to apologise for her child. Instead she said, "Pádraic, you had no authority at all to do that. You have upset my child very much." I maintain it should have been the child's parent's responsibility to correct him, not mine. Probably I lost a vote but I hope I did that mother and child some good.
I contend that parents are not sufficiently responsible, not merely in relation to the subject before us. We listened too long to Dr. Spock. Dr. Spock and Irish parents have much to answer for. Let us take our responsibilities seriously and talk to our children about discipline and responsibility. That incident in Galway on Monday last was more enlightening for me than 100 lectures on parents' responsibilities. I hope it will have done some good.
We should take our responsibilities in this matter seriously. We are all in this together, let us play our rightful part. If we adopt an attitude of openness and responsibility to our children then where condoms may be available, whether in pubs, shops, through vending machines, or on the roadside, will matter much less. I acknowledge that it is not an easy task but it will be much less difficult once we begin to educate our young people in proper sexual behaviour, with proper sex education in our schools and particularly within our families.
I thank Deputy McCormack for sharing his time with me. Deputy Creed said we should legislate for reality, not morality. I contend the Minister has become caught between two stools, is endeavouring to legislate for both, which is extremely difficult. We legislators must legislate for what is taking place in the real world.
There is an urban-rural divide in the provisions of this Bill. The Minister has introduced the Bill without taking into account extreme difficulties encountered in many rural areas on the part of young, sexually active people who experience great difficulty finding non-medical contraceptives or condoms. While appreciating that the Minister has been progressive in his endeavours he has not taken these difficulties into account. The provisions of this Bill will not render their task any easier. If any young person attempts to ask for a packet of condoms in any outlet in rural areas he or she will be asked many questions, with many comments being made simultaneously, which will inhibit them. This can be resolved only by installing vending machines in public places. I do not recommend their installation at every corner or public place nationwide. Proprietors of pubs, discos and the like should be allowed decide whether they want them installed on their premises.
I happen to live approximately ten miles from Northern Ireland and have socialised there along with friends. In recent years condom vending machines have been installed in public places in Northern Ireland. The people of Northern Ireland, and none of my friends, suffer any sexual depravity because of the availability of condom vending machines there.
We have much to answer for because of the lack of sex education in this country. However, the time available does not allow me go into that matter in greater detail. I perceive this to be a type of "nod and wink" Bill because its provisions mean that young people will have to ask for condoms in retail outlets. Privacy is essential in sexual relationships. None is afforded when somebody must ask a barman, or a shop assistant, for a packet of condoms.
While an age limit on the purchase of condoms may be morally plausible I contend it is totally unnecessary and will be impossible to police. Numerous Members have made the point that the provisions of the intoxicating liquor legislation here are not capable of being policed. As a country, we experience major difficulties with regard to under-age drinking. I predict we will experience the same difficulties with regard to the age limit on the purchase of condoms.
As I said in my introductory remarks, the provisions of this Bill are urgently required to tackle the problems of sexually-transmitted diseases, including HIV/AIDS. I am pleased to see there is a consensus in this House that the thrust of the measures proposed in the Bill are a practical and sensible contribution towards this end.
In regard to the 17 year age limit, the Bill provides that condoms may be supplied from a wide range of outlets and that the age at which persons can obtain condoms should be reduced from 18 years to 17 years. Deputies will be aware that I have already referred to the representations and the approaches which I have received from parents — not fundamentalists or anyone like that, just concerned parents — that I must take into account. I am not legislating for John O'Connell. This is a Bill with full Government approval to meet the needs of the people and to respect the fears and anxieties of parents. We are all parents, we all have children and we are all genuinely and understandably concerned. Whatever our own personal views on this subject are, we must take cognisance of the views and reservations of parents in implementing legislation which provides for the wider availability of condoms. We must strike the correct balance between the concerns of these parents and the requirement to take measures to protect public health.
It can be contended that the present Bill in the context of an age limit of 17 is consistent with the development of the preventive elements of the National AIDS Strategy Committee and the dictates imposed by the continuing high prevalence of other sexually transmitted diseases.
It does not interfere with the right of married couples under the age of 17 years to obtain contraceptives freely. I will also have to consider the question of single parents. It also contains a provision which enables contraceptives to be sold to a person under the age of 17 years in respect of whom a prescription has been issued by a registered medical practitioner.
It can be contended that the Bill represents a significant liberalisation of outlets through which condoms may be sold and, by extension, greater access to condoms for those who require them.
I would say that there is nothing very special about vending machines. What I want to say is that we have had the notion here that sex is sinful. This notion has permeated our society for a very long time. Maybe it is a good idea that we ask people to go up and ask for them; there is nothing disgraceful, nothing wrong, nothing sinful, nothing morally wrong in sexually active people asking for condoms.
They will not do it.
What is so difficult about it? Is a person committing a crime?
Some will not do it.
Are they going to get AIDS as a result?
Acting Chairman:
Let us hear the Minister without interruption, please.
We want to get rid of the notion that sex is wrong. Maybe the best thing we have ever done is to ask people to do this, to go and ask for condoms. We have come a long way from the time of the debate on the 1985 Bill. We would be appalled today if the 1979 Bill were brought in but it met the needs of the time. The 1985 followed. While we must make the public understand, we have to realise and have concern for their feelings and fears. This is a good measure, but I wonder what would have been the response had I said that there would be total deregulation. I would love to read the speeches that would have been made by Opposition Members. I was congratulated by an Opposition spokesman for the stand I took in liberalising their availability as far as possible. I have gone some way towards meeting the wishes of people.
I should like to respond to a number of points raised. Deputy Howlin mentioned the position in regard to oral contraceptives. Such products are technically subject to the provisions of the family planning legislation and of the controls relating to medical preparations operated by the Department of Health in conjunction with the National Drugs Advisory Board. In reviewing the requirements to meet the evolving AIDS problem I formed the view that it is not essential to maintain the controls over them under the family planning legislation. I felt it was much more important that they come under legislation dealing with medicines. Condoms are primarily designed to prevent conception and I am satisfied that the sale of condoms for other purposes, such as to prevent infection, would not be precluded under the Bill. That is my thinking.
A question was raised about the supply of contraceptives. On the basis of discussions with the Office of the Attorney General I gathered that the ordinary dictionary and everyday meaning of supply relates to continuous commercial activity where transactions take place between persons or companies re goods or services. These meanings do not relate to ad hoc activities between individuals and the Bill does not purport to control any such ad hoc activities.
Section 9 enables the Minister to provide grants to assist research into methods of family planning that do not relate to the use of contraceptives but the Minister may grant-aid a variety of organisations under section 65 of the Health Act, 1953. The Minister can make grants available for other types of research——
But none has been made in this area.
——and it is important that we should know this. Section 65 states:
A health authority may with the approval of the Minister, give assistance in any one or more of the following ways to any body which provides or proposes to provide a service similar or ancillary to a service which the health authority may provide:
(a) by contributing to the expenses incurred by the body,
(b) by supplying to the body fuel, light, food, water or other commodity,
(c) by permitting the use by the body of premises maintained by the health authority and, where requisite, executing alterations and repairs to and supplying furniture and fittings for such premises,
(d) by providing premises (with all requisite furniture and fittings) for use by the body.
(Interruptions.)
Acting Chairman:
The Minister should be allowed to make a Second Stage speech in reply to the queries. Deputies can raise these other issues on Committee Stage.
I make the point that there is provision. I would be very opposed to the sectarian approach and would not want it included.
Deputies Bruton and De Rossa made a point about a prohibition on treatments for sexually transmitted diseases under the Indecent Advertising Act, 1889, as amended by the Censorship of Publications Act, 1929 and contended that this was carried into the Family Planning Act, 1979. I would like to clarify that the Venereal Disease Act, 1917 does allow such advertising by health authorities. There is no need for an amendment to the 1979 Act to enable such advertisements to be placed.
I wish to make some further points about advertising. I will be making some changes to the regulations which are in force under the 1979 Act. I have indicated a number of areas where I will be bringing forward new regulations and, during Committee Stage tomorrow, I will explain how certain of the current regulations will no longer apply in the light of the repeal of sections of the principal Act.
One aspect of the regulations which I will be considering in detail is the current provision with regard to advertising and display of contraceptives. Section 7 of the 1979 Act provided that a person could not take part in, or procure, the publication of an advertisement or notice in relation to contraception or contraceptives or display, or procure the display of, contraceptives except in accordance with regulations.
The 1980 regulations provided that publication or display should be (a) related to family planning services authorised under the Act or (b) reasonably necessary for the purposes of informing: (i) persons providing family planning services under the Act; (ii) registered medical practitioners; (iii) registered chemists and druggists; (iv) registered nurses; (v) trainee doctors, chemists or nurses, or (c) where the publication or display is arranged by or on behalf of the Minister.
It is fairly obvious that these provisions are out of date. All Deputies will agree with me on that. They were framed at a time when the acceptability of advertising and displaying condoms, for example, was quite different.
Today we are talking about a serious public health issue. We want to encourage young people and all who are sexually active and may be at risk to take sensible precautions against both sexually transmissible diseases and unwanted pregnancies. This is important. The new outlets should be able to display condoms, as should the traditional outlets, many of which may have had concerns about advertising and displaying contraceptives for some time.
I will be looking at the changes which should be made to the current regulations to bring them into line with the provisions in the Bill.
Deputy Creed mentioned the lack of educational programmes on sexuality in the formal schools system. I intend to have discussions with my colleague, the Minister for Education, on this issue of AIDS but I would like to clarify that the Departments of Health and Education are implementing an AIDS education programme in secondary schools at present. Teachers have received guidance on how the programme is to be delivered. The programme has been well received and I am happy to say that internationally the AIDS education programme for schools has been praised.
Deputy Dukes was adamant in making the point about fundamental rights but he was singularly silent during the debate on the Bill in 1985 when he was a Minister. He said he did not think there would be any increase in the number of outlets selling condoms in a year's time. If retail outlets will not sell condoms over the counter we have no reason to believe they will accept vending machines. Deputy Higgins was very quiet at that time. If he had radical views he kept them very much to himself.
The Minister must not have listened properly to Deputy Higgins if he thought he was quiet.
Seven years have gone by and we now think differently.
I read into the record——
On a point of order——
Acting Chairman:
I will not allow a point of order when the Minister is replying.
The Bill is an appropriate response to this issue at this time. As I said, as legislators we have an obligation to listen to the views of the public; we do not have a monopoly on wisdom in regard to this matter. We have to be guided by the views and concerns of the people we represent. A number of improvements have been made in this Bill which take account of the concerns expressed about the previous Bill. This is a serious issue which needs to be tackled urgently. This is why the Government allocated time for a debate on this Bill before the summer recess. We need to act now in the interests of public health.
I commend the Bill to the Deputies for the reasons I have outlined. I believe the Bill will meet the wishes of the majority of Irish citizens. I thank the Deputies who contributed to the debate.
Question put and agreed to.
Committee Stage ordered for Thursday, 9 July 1992.
Sitting suspended at 2.15 p.m. and resumed at 2.30 p.m.