I listened to Deputy Kemmy speak of the greater realism in this House. He also mentioned that there was sadness. It struck me during the debate that there is a lot to be sad about because the energy and effort that has gone into this tortuous debate over the years has had implications in people's lives. There may indeed have been a great deal of personal tragedy caused by the failure to address this issue in a comprehensive way before now.
I welcome the provision in this Bill for free availability of condoms, but it is ironic that in taking this step the Minister is excluding them from the definition of a contraceptive, that is, the means by which people can prevent pregnancies.
The shift in public opinion is in terms of the openness of the sale of contraceptives. Undoubtedly this has been brought about in some measure by the tragedy of AIDS and the serious health questions which it poses. Again, I would congratulate the Minister on the approach he has taken in this area. I would congratulate him on the public information campaign which is in place at the moment. I would urge him, however, to consider further public information campaigns targeting women particularly. International research is showing that women are vulnerable to AIDS and they need to be well informed. My own experience, working as a social worker, has shown me that many of the most disadvantaged women in our society are not getting the sort of information and advice they need.
The shift in public opinion is not just in this area. We also saw it following the X case last year. I am convinced that increasing numbers of Irish people are quite clear that we must also be open and willing to deal with sexuality as a more complex issue, that we cannot pretend that crisis pregnancies do not exist. A number of Deputies mentioned this. We have to look at the question in a much more open way. That involves educating our young people in the whole area of life skills and sexual relationships. We know that young people are risk takers and that we have to discuss with them and inform them about the consequences of taking those risks. We have to give people the opportunity to make informed choices about family planning so that they can make the right decisions for themselves morally and healthwise.
Condom availability is just one piece of a jigsaw puzzle if we are serious about creating a healthy attitude about sexuality. Another piece of that jigsaw is the inclusion of the pill within the medical card system as a contraceptive rather than a cycle regulator, as has been the case. Undoubtedly these two measures will have benefits, but I would urge the Minister to develop the debate further, if not today then at a later stage so that we can take a more comprehensive view of this very important issue for Irish women and men.
All too frequently people have no proper access to advice and information in the whole area of family planning. This has been a completely grey area, unspoken of and not dealt with in a courageous way by the State or by the health service.
The Minister has made condoms more available and also the pill, but what about access to a broader range of family planning methods? Are doctors' consciences to continue to override the conscience of their patient? Does the Department know which doctors will provide a full family planning service, where there are gaps, and what steps are being taken to provide such a service?
To make informed choices people need information, and simply saying that the pill or condoms are more available does not address this. How is information to be made more accessible? How are health personnel to be trained to provide the wider service? I acknowledge the work of many in the medical profession in this area. Perhaps a survey of GP and health board plans for the provision of service could answer some of those questions. Such a survey should be undertaken as a priority.
Mention has been made of the many voluntary organisations who are working in the area of AIDS prevention. I pay tribute to them and to the work which they have done. I pay tribute particularly to the strategy commission and people like Dr. Walsh who have spoken out so clearly and have been so articulate about this issue in a society that does not really like to face up to the realities surrounding many of these issues and which has been reluctant to do so for many years.
Irish men and women have, however, been well served by organisations, often voluntary, and doctors who were courageous enough to provide family planning services when the State and the formal health sector did not want to know. I hope that their work can now be acknowledged. Their continued operation of emergency services in towns around Ireland is one indication of how far behind the health service has fallen in meeting the real as opposed to the perceived needs of Irish people.
I welcome the Bill. It is one important part of a response but only one part. We need the comprehensive approach which I have spoken about. I would urge the Minister to ask the committee looking at women's health needs in the Department of Health to look at the recommendations in this area in the Report of the Commission on the Status of Women. It is clearly a critical part of the issue of women's health. It is central and there is a range of actions which the commission suggests needs to be taken. I hope the Minister can initiate the sort of debate we need in this area and ensure that we have the widest possible and most comprehensive approach to this issue.