Health and Social Care Professionals (Amendment) Bill 2016: Second Stage [Private Members]

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

Approximately ten years ago a small organisation came into existence called Choice Ireland.

It was founded after a public meeting about the eighth amendment to the Constitution organised by Labour Youth. During its period of activity, I have no doubt that this organisation helped move the conversation in Ireland considerably towards a detailed and reflective consideration of the eighth amendment.

One of the actions the group undertook was to highlight the extent to which rogue agencies lied to women in crisis pregnancy agencies. I know one of the women involved in the group very well: Sinead Ahern is the chairperson of Labour Women nowadays. She was one of a small number of women who went undercover to determine the true extent of what was going on in these so-called rogue agencies. When speaking about this issue recently, Ms Ahern noted her shock in discovering that these same agencies still operate a decade later. Somehow, we have all collectively looked the other way for the past number of years. It took the brave work of two journalists, Ellen Coyne and Catherine Sanz of The Times, to bring our focus back to the lies, the deceit and sometimes the grotesque mistruths being told to women in crisis pregnancy situations.

However, it is not enough for us to express our horror or outrage and then for the issue to disappear once more. To do so would leave these agencies operating for another decade, abusing countless women when they are in most need of care, support and, above all, the truth. It is no longer tenable to stand over a situation in which dieticians and opticians must be regulated before they can offer any service to the public but those counselling women in vulnerable situations face no requirement to register or be regulated at all. It is not good enough for us to stand over a situation in which women are being lied to in what sometimes amounts to a grotesque fashion at a time of vulnerability. Women in crisis pregnancy situations are being told that abortion increases a woman's risk of breast cancer or that women who have had abortions will later abuse or neglect any children they might have. These are lies told to scare, humiliate and denigrate women and, most of all, to prevent them from having access to the impartial information to which they are entitled before they make choices for themselves.

We are long past time for an honest conversation about gender equality in Ireland. We continue to hear a litany of statistics about the enduring problem of domestic violence in this country. We heard again this morning about the persistence of the gender pay gap, which amounts, in the analysis done, to 20% between men and women. Too many women remain in low-paid, insecure work. Too few women are breaking through the glass ceiling of senior roles in the public and private sectors. Access to affordable child care in Ireland for every family still looks like a distant dream. We have, thankfully, more women in this House than ever before. Waking the Feminists is doing exceptional work to improve the position of women in theatre in Ireland. There are other efforts to increase the number of women on State boards, in academia, in science careers and elsewhere. However, we still have a long way to travel on the road to true equality and we need to have a broader discussion on these matters. The discussion is happening outside this Chamber. It is time we began a frank discussion here too. Today we deal with one way in which we permit the mistreatment of women in Ireland. Rectifying this problem will not solve all the other issues I have mentioned, but even the elimination of this one injustice will represent a step towards equality, and every step on that journey matters.

For all the reasons I have outlined, I believe new legislation is needed to regulate this area. We in the Labour Party have chosen the Health and Social Care Professionals Act as the vehicle for the proposed reform. It is the vehicle best suited to deal with the elimination of rogue counselling agencies from the spectrum. That Act applies to the newer health and social care professions outside the traditional core sectors of medicine and nursing. The Act establishes registration boards for those designated professions, it protects the use of the titles of those professions and it provides for the resolution of complaints relating to fitness to practice.

There may be some practical difficulties in applying this Act to crisis pregnancy counsellors. I have discussed my proposal several times with the Minister for Health, Deputy Simon Harris, here present, and with his officials and I thank him for the frank and forthright way in which he has approached this difficult and sensitive issue. I acknowledge and appreciate that the Minister is anxious to co-operate on the Bill and accommodate what he recognises as much-needed reform in this area and that he has instructed his Department and its officials accordingly. As I understand it, the problem, from an administrative perspective, is that the Health and Social Care Professionals Act applies automatically to certain professions directly named in the legislation itself. These include, for example, chiropodists, occupational therapists, physiotherapists and psychologists. These professions already have what we might call the infrastructure of a recognised and regulated profession, namely, a defined scope of practice, a representative professional body, defined routes of entry and recognised qualifications. The Act goes on to enable the Minister by regulation to designate additional health and social care professions. He does so by reference to the stipulated factors. In other words, the Minister assesses whether the profession has in place the infrastructure to enable it to be regulated. Normally speaking, the path towards recognition and designation may take months, if not years, involving consultation, assessment, the satisfying of preconditions and so on. I propose in my Bill to fast-track this process for those involved in pregnancy counselling.

I propose to amend the Act itself so as to include these professionals in the category of those directly designated in the Act. I do so unashamedly and for a reason spelled out in section 4(4)(e) of the 2005 Act. In deciding whether it is appropriate and in the public interest that a particular health or social care profession be designated, we as legislators insisted in that section that regard must be had to "the degree of risk to the health, safety or welfare of the public from incompetent, unethical or impaired practice of the profession". I want to home in on this factor, which is the reason I propose this amendment. Giving incompetent, unethical and impaired advice or counselling to vulnerable women with crisis pregnancies represents an unacceptable risk to their health, safety and welfare. In these circumstances, I do not believe we have time for a more leisurely route. Immediate action is warranted. As I said, the Minister and his officials share these concerns and have signalled they are anxious to work co-operatively to secure a workable way forward. A departmental consultation process is already under way in respect of counselling generally, but crisis pregnancy counselling has not as yet been specified as a separate social care profession. I recognise there are practical hurdles. However, if we do nothing and simply await developments, I do not believe we will see, in any acceptable timeframe, the necessary criteria being satisfied by the profession itself.

We will not see agreement on a defined scope of practice, a representative professional body or agreement on recognised qualifications. It may be, when we have had an opportunity to consider this further in committee, that we will find a solution which combines aspects of this body of legislation with another Act that I had some involvement with when I served as Minister for Health a number of years ago.

I refer, in this regard, to the Regulation of Information (Services outside the State for Termination of Pregnancies) Act 1995. The latter arose from the 14th amendment to the Constitution, which enshrines in the Constitution that Article 40.3.3° cannot be used to limit the freedom to receive and impart information about services available in another state, subject to such conditions as may be laid down by law. The 1995 Act lays down those specific conditions and seeks to reflect an appropriate balance between the constitutional rights and freedoms bearing on the question of abortion information. The Supreme Court had decided in a number of cases that the dissemination of information on abortion, such as the name, address and telephone number of a foreign abortion service and the method of communication with it, was unconstitutional. However, the European Court of Human Rights had held that these Supreme Court injunctions were in breach of Article 10 of the European Convention relating to freedom of expression and the right to receive and impart information. The legislation we passed to give effect to the 14th amendment sought to clarify the legal entitlements and obligations of persons and agencies that provide abortion information and to ensure that any doctor or advice agency that provides abortion information to pregnant women does so only in the context of full counselling on all of the available options, without any advocacy or promotion of abortion.

From discussing the matter with the Minister's officials, I understand that he and they emphasise section 5 of the Act. That section applies to anyone who engages in the activity of giving information, advice or counselling to individual members of the public with regard to pregnancy. The section states that where such a person is requested by a pregnant woman to give information, advice or counselling on her particular circumstances, it is not lawful for that person to give what is called "act information" to the woman unless the information, counselling and advice are "truthful and objective". The Department's view is that a rogue counselling agency may well be in breach of that statutory requirement. In other words, it may be found that the information it provides, if not fair and accurate, is in legal terms not truthful or objective.

I have no problem with that, as far as it goes, but it is important to bear in mind that the scope of the 1995 Act is confined to a specific type of information, or what it calls "act information". This is defined as information likely to be required by women in availing themselves of pregnancy termination services. In other words, "act information" relates to that information which helps somebody have an abortion, and, in reference to the subject matter of the original Supreme Court injunctions, it means providing the name, address and telephone number of a foreign abortion service and so on. Thus, as then Minister for Health, Deputy Michael Noonan, pointed out on Second Stage of that Bill in this House, the Act does not apply to more general information, such as information about the nature of abortion. If a rogue agency, which seeks to restrict access to abortion, provided women with information that was objectively untruthful, it might do so without being subject to the legislation.

I am conscious that my time has almost expired. It is important that we have a workable solution to outlawing this practice of giving totally inaccurate, misleading and damaging information to women at a time of crisis. We believe our proposed legislation is the best and quickest method to do this. I welcome the support for the principle of the legislation from the Minister and I look forward to working with him to find a mechanism that will bring a form of legislation to the Statute Book at an early point to achieve these objectives.

I begin by thanking Deputy Howlin for raising this timely and very important issue and for the co-operation he has demonstrated with me and my officials in working on this matter in recent weeks. I am supporting this Bill on Second Stage because I am fully supportive of the objective behind the legislation, which is to protect the public and women of Ireland. I pay tribute, as Deputy Howlin has done, to the investigative work of Ms Ellen Coyne and Ms Catherine Sanz that has resulted in us perhaps having this worrying issue that we are now endeavouring to address on the floor of the Dáil this evening.

The people requiring protection in this case are women who are experiencing crisis pregnancies and seeking support at a time of extreme distress and vulnerability. Instances have come to light where services purporting to provide objective advice and support were serving their own agenda with little regard for women, their health or welfare. Health information should be just that, not an opportunity to push an agenda, mislead or scaremonger.

My Department has assessed the Bill, as drafted, and we do have some concerns, alluded to by Deputy Howlin, and there is a need to rework some elements to achieve our shared objectives. However, I look forward to engaging constructively with the Deputy on the Bill. Rather than doing what has been done before in the House with a timed amendment, we are, as I discussed with Deputy Howlin, taking a different approach because I was worried that it would send a signal that we are not attaching the required degree of priority to the issue. It is appropriate that the House pass this Bill on Second Stage and that we work constructively to formulate the appropriate solutions to achieve our shared objective. Subject to the Bill passing Second Stage, I will make available the resources of my Department for this purpose. I hope we can work with Deputy Howlin to achieve the best result for women.

I know Deputy Howlin, as a former Minister for Health, is very much alive to the duty to protect the public when availing of health or social care services. As I have said, this concern is shared by me and the Government, especially when it comes to pregnancy counselling services. A crisis pregnancy is perhaps one of the most stressful events in a person's life and can place a woman in a very vulnerable position. Positive Options, the crisis pregnancy service that is funded and overseen by the Health Service Executive, provides counselling in 50 locations nationwide and provides women with free, non-judgmental counselling. We are all aware, however, that some other bodies providing counselling to pregnant women may not adhere to the same standards. There have been media reports, as I have alluded to, of such bodies providing information that is not truthful or objective and this is a cause of concern. It is more than that; it is repulsive, spineless and unacceptable to any right-thinking person. It should not and cannot be tolerated. To address that concern Deputy Howlin has put forward this Bill, which seeks to address the matter by regulating crisis pregnancy counsellors. I have some legal and practical difficulties with the detail of these proposals, as I noted, but I agree there is a very important role for the regulation of relevant professionals in this area. I hope we can find a means of achieving such regulation and I will outline developments for the House that are very relevant in doing so.

Before I do so, I am announcing tonight that, in tandem with our consideration of this Bill, my Department is commencing a review of the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995 as part of our response to addressing the concerns that have arisen. This is an issue that has been raised with me by Deputy Howlin and the Terminations for Medical Reasons group at our meetings, as well as by individual women I have met over the past six months or so. The 1995 Act provides it is an offence for bodies or counsellors to provide information on termination of pregnancy that is not truthful or objective. Allegations of providing such information may be referred to the Garda Síochána for investigation. These provisions are already on the Statute Book and it is important that people with concerns about the veracity of information given by service providers are aware that there is an existing basis for having their concerns addressed. The review I asked my Department to conduct will set about establishing if these provisions need to be strengthened. We will also examine other relevant issues and concerns that have been raised.

On the issue of professional regulation, it might be useful for me to outline the progress that has been made in implementing the Health and Social Care Professionals Act 2005 and to provide some information on how it operates in practice. The 2005 Act provides for the statutory regulation of 14 designated health and social care professions: clinical biochemist, dietician, dispensing optician, medical scientist, occupational therapist, optometrist, orthoptist, physiotherapist, podiatrist, psychologist, radiographer, social care worker, social worker and speech and language therapist. I hope that is 14.

Regulation under the Act is primarily accomplished through the statutory protection of professional titles by confining their use solely to people who have been granted registration. The structure of the system of statutory regulation comprises registration boards, a committee structure to deal with disciplinary matters and the Health and Social Care Professionals Council, known as CORU, which has overall responsibility for the regulatory system. CORU is responsible for protecting the public by regulating health and social care professionals in Ireland. CORU is also charged with promoting high standards of professional conduct and professional education, training and competence among registrants. The 2005 Act provides for a transitional "grandfathering" period of two years during which existing practitioners must register on the basis of specified qualifications. After this period, the only people who are entitled to use the relevant protected title are those registered with the registration board who are subject to the Act's regulatory regime. To date, the registers of eight of the designated professions have been established. The remaining professions are following close behind. I expect that the registers of all 14 professions will be open by the end of 2017.

While it has been a long and difficult journey for all involved, much valuable learning has been gained along the way. From a public protection viewpoint, a crucial milestone in the regulation of the designated health and social care professions designated under the 2005 Act was the introduction at the end of 2014 of the fitness to practice regime under the Act. This allows complaints about the conduct or competence of registrants to be investigated and, where complaints are substantiated, disciplinary sanctions up to and including cancellation of registration to be imposed. The regime is similar to that which applies to medical practitioners, nurses and midwives. A code of professional conduct and ethics, which sets out the standards of conduct, performance and ethics to which registrants must adhere throughout the course of their work, is central to CORU’s fitness to practice regime. Each profession that is registered has its own code. As part of an application to join a register, all registrants will have signed a statutory declaration stating that they have read, understood and agreed to abide by the code for their profession. Failure to adhere to the relevant code is grounds for a fitness to practice complaint.

I would like to update the House on the relevant proposals to regulate counsellors and psychotherapists, as alluded to by Deputy Howlin. At present, these professions are not designated under the 2005 Act, which provides that the Minister for Health may designate by regulation health or social care professions not currently designated if he or she considers that it is in the public interest to do so and if the specified criteria have been met. A previous Minister for Health, Senator James Reilly, wrote to the Health and Social Care Professionals Council on the question of designating, in the public interest, the profession or professions of counsellor and psychotherapist under section 4(2) of the Act. The 2005 Act provides that the Minister for Health is obliged to consult with the council in the first instance concerning a proposed designation and to give interested people, organisations and bodies an opportunity to make representations to the Minister. The council was asked to consider a number of issues concerning the proposed designation and was requested to take into consideration Quality and Qualifications Ireland's report on the academic standards necessary for the accreditation of courses in counselling and psychotherapy. This was the first stage in the consultation process under the Act.

On 31 August last, having received and considered the report from the council, I proceeded to the next stage, which involves a public consultation to include all interested parties. As mentioned earlier, I have asked that submissions be forwarded to my Department by the end of this month. While a number of key issues remain to be clarified, including decisions on the title or titles of the profession or professions and the minimum qualifications to be required of applicants for registration, I hope the necessary designation regulations can be submitted to the Oireachtas for its approval next year. Expressions of interest will then be sought via the Public Appointments System from suitably qualified people who are available for appointment to the new registration board that will be established to regulate counsellors and psychotherapists. This is a massive body of work. It is important for the Oireachtas to get it done for once and for all in an appropriate way.

The forthcoming developments with regard to the registration of counsellors under CORU are highly relevant in determining the best means of regulating pregnancy counselling other than that provided by professionals such as doctors, nurses or social workers, who are already regulated. As Deputy Howlin has outlined, his Bill proposes to amend the 2005 Act to designate crisis pregnancy counsellor as a profession. It would treat pregnancy counsellors separately to counsellors generally and would define their scope of practice. While I am not convinced that this would be the best approach in practice, I wish to tease out the issue further with the Deputy. The establishment of crisis pregnancy counsellor as a profession separate and distinct from the profession of counsellor would give rise to difficulties. Pregnancy counselling does not meet the standard criteria for designation under the 2005 Act. In particular, it has not established itself as a separate profession with its own professional body, defined routes of entry and distinct entry qualifications etc. Unlike the general profession of counsellor, the number of people in the profession of pregnancy counsellor would be very small. Most providers of pregnancy counselling are members of other regulated professions such as counsellors, medical practitioners, nurses and social workers.

The Bill also seeks to regulate the profession by defining the activity engaged in by pregnancy crisis counsellors. The 2005 Act regulates professions by setting qualifications and protecting title; it does not regulate activity or define scope of practice. As I mentioned earlier, registrants are obliged to adhere to a code of conduct and ethics specific to their profession. Failure to do so is a ground for a fitness to practice complaint. The Act provides that only those who are registered can use the protected title. The ultimate sanction under the Act is the cancellation of registration and the consequent removal of entitlement to use the title. For that reason, the inclusion of references in the Bill to "the activity of giving information, advice and counselling to pregnant women in relation to crisis pregnancies" needs further careful consideration. A range of professionals engaged in such activity are regulated by CORU and other regulators such as the Medical Council. We want to retain the everyday important contribution of such professionals to supporting women in crisis pregnancy situations and in a way that relies on their existing professional regulation, which reflects their professional affiliation and standing. In addition, the Bill before the House does not take account of the difficult but key requirement to set grandfathering qualifications, which is central to the registration of existing practitioners. There is also the matter of having to provide for the establishment of a registration board and a range of consequential amendments to the 2005 Act.

I make all of these points in the desire to be constructive and make progress. I will ask my officials to continue their current engagement with Deputy Howlin and other interested Deputies on these issues so that we can arrive at the points that I believe we collectively as a House wish to arrive at with regard to this important issue. While I support the Bill being read on Second Stage, I feel obliged to point to the additional work we need to do in this area. I am committed to working with Deputy Howlin on this matter. I have asked my officials to give timely consideration to ways of better protecting the public from certain crisis pregnancy agencies or counsellors that are providing information that is clearly neither truthful nor objective. The intention will be to make progress through forthcoming registration of counsellors, the existing Regulation of Information (Services Outside the State For Termination of Pregnancies) Act 1995 and the review of the 1995 Act I am announcing this evening as a sizeable and important body of work. I look forward to keeping the House updated. I look forward to this legislation progressing beyond Second Stage, as I hope it will do, so that we can work together to make sure women in this country are provided with factual and truthful information, rather than some of the despicable and disgusting issues we have read about in the media recently. The women of this country deserve better. I am determined to work with Deputy Howlin to achieve the objectives he is setting out to achieve.

I congratulate Deputy Howlin on introducing this legislation in the Dáil. I thank the parties that have accepted that the legislation should be able to proceed. This legislation is important for women, particularly younger women, who might potentially have a crisis pregnancy and seek the advice of rogue or fake crisis pregnancy agencies. This modest proposal is being made by the Labour Party to remove an abuse of pregnant and vulnerable women who may be used and abused by bogus crisis pregnancy agencies. I refer to agencies that seek to give bad and, in some cases, downright dangerous advice to women who come to them genuinely to seek a range of advice about the dilemmas they are facing in the context of their pregnancies. I want to make it clear that the Bill is not about imposing a particular ethos for assisting women in crisis pregnancy situations.

There are many legitimate crisis pregnancy agencies funded by the HSE that meet strict criteria. On the one hand, there are agencies such as the Irish Family Planning Association, which I want to specifically thank for the assistance it has given in drafting this legislation, and the Well Woman Centre. On the other, there are legitimate agencies such as CURA that are up-front about their particular religious and Catholic ethos. The Bill is in no way a threat to these legitimate services.

What the Bill seeks to tackle are rogue agencies, those disingenuous services that do great harm. Research has shown that women who attend unregulated counselling services are often put off seeking assistance from a legitimate provider after what is the horror of their experience. Many of these unlicensed agencies are linked to a nationwide network. We know this from some of the people who have gone to find out about the services. For example, I know of one case where a person was seeking advice from a Donegal-based address and almost immediately the person was told that someone could meet them in a car park in one of the Donegal towns, not in a proper office. The people in the service were so anxious to meet that person that they were available at the drop of a hat. We know some of the things that have been said from the work of a number of people, including journalists who have examined this issue.

Vulnerable woman at times suffer a terrifying experience. They are told they will be very ill in later life and are candidates for cancer, or that they will never have another baby, or, if they do have a baby, that they are at risk of abusing that baby. All of the data shows that those who end up in the hands of what is basically a rogue advice centre very often go out the door and do not go back to anybody else for advice. In a situation where they are already trying to make a very difficult decision as to how they address a crisis pregnancy, they are essentially brought into a situation and given what, for many, can be terrifying advice. We are all familiar with the concept of old wives' tales but these tales are specially tailored to strike fear into women's hearts and, in many cases, they make people forever after very vulnerable in the context of a difficult phase in their lives.

While the Minister is present, I want to make reference to the Crisis Pregnancy Agency, which was founded more than a decade ago, in Fianna Fáil's time. The Crisis Pregnancy Agency was chaired very effectively by Olive Braiden and did a huge amount of work to publicise the concept, through the HSE, that advice was available from a variety of advice providers to allow people to address the situation in the context of their own ethos, beliefs and circumstances. That agency was very effective. It has since been absorbed into the HSE, within which it is a unit or office, but I believe it had better visibility when it had an independent chair. It sent out a message to all of the different organisations involved, given there is a network of advisory agencies throughout the country which provide a range of advice on different options. When getting advice, most people want to look at the options and it is important they are able to do that. The Crisis Pregnancy Agency started the first campaign to tell women to stop being manipulated if they end up, as it were, in the clutches of one of these rogue agencies. In fact, at the time many women in the Dáil, from all the different parties and from none, got involved in getting the information in regard to their own areas and being able, if necessary, to pass on that information and make it available. It is one of the aspects the Minister might examine because the Crisis Pregnancy Agency also reached out to many women's organisations, aside from the professional counsellors.

The Labour Party Bill seeks to protect the title of "crisis pregnancy counsellor" and to make it an offence to falsely pose as a crisis pregnancy counsellor. Given the regulation of the medical profession, we are all now used to reading distressing cases from time to time where people end up acting as doctors or nurses and it turns out they are bogus. Given some of the information that has been made public, which I am sure the Minister has pored over in his time, it is hair-raising to know an adult or a child could end up in the hands of somebody who is not qualified to practice. People go to a counsellor because they feel they need to talk about a situation and they need advice. It is very likely the purpose of the visit is to help them to reach a decision. If that advice is given in bad faith, against all professional norms, it can do huge, long-lasting damage that results in a person's subsequent capacity in regard to relationships, whether with adults or subsequently with children, being damaged, or in a person feeling some kind of guilt. When one talks to people who have been through this, it is clear the experience is very negative. If the person giving that advice was also posing as a doctor, a nurse or even a teacher, we would all understandably be extremely upset and we would not want the risk of harm that such people pose.

It is no longer tenable to stand over a situation where dieticians, opticians, doctors, nurses and so on are regulated but those who counsel women in vulnerable situations face no such requirement. The agencies that are properly regulated and accountable to the HSE practice to a particular professional standard. It is not good enough for us to continue to stand over a position where women are being lied to in a grotesque fashion at a time of exceptional vulnerability. Women in crisis pregnancy situations are being told new wives' tales about what may happen to them in terms of the risk of diseases, in particular the risk of cancer, or that women who have abortions will later come to neglect and abuse their children. These are lies told to scare, to humiliate and to denigrate women.

The Bill applies to the newer health and social care professions outside the traditional core sectors of medicine and nursing, and I recommend it to the House.

There are people here with a wide range of views but really bad advice is very damaging. Those on particular sides of the argument about the eighth amendment may feel that they should automatically take one side or the other. Somebody looking for advice probably has several options in mind and the critical point is that said advice should allow that person make a decision she wishes to adopt. That is the purpose of the advice; it is not for the adviser to be a warrior in a campaign to make a woman act in a particular way.

I congratulate Deputy Howlin on bringing forward this legislation on behalf of the Labour Party. I welcome the fact that the Minister for Health has indicated he will not be opposing it. His contribution was very constructive in engaging with what the Labour Party is trying to achieve, namely, to ensure that false information is not given to women in the extremely vulnerable situation of trying to make a very difficult decision in circumstances of being pregnant without intending it. They, therefore, have to consider all the options available to them and all the circumstances of their lives and those of the people around them. If any of us were to think of what it is like to be in that situation, the last thing we would need would be to be lied to by being given information that was not correct. The two previous speakers have described the kind of information that is given. The information that particularly upset me, as a mother and a woman, is the idea that a woman might go on to abuse her own children because she has had an abortion. That is an extraordinarily offensive thing to tell any woman and something that would be deeply worrying to a woman who might believe it to be true. It is extraordinarily dangerous to give that kind of information to a woman, as it is to suggest that she might somehow be more likely to get cancer in later life if she has an abortion.

We are not seeking to direct people as to what decision they should make but to ensure that the information they are given is accurate and that they will not be told that having an abortion is going to have an effect, particularly as there is absolutely no evidence to suggest that the latter might be the outcome. That is why we want to ensure that such rogue pregnancy agencies are completely outlawed. That is the urgency of Deputy Howlin’s point in amending the legislation to include rogue pregnancy agencies in the Bill and, therefore, that, under the terms of the Bill, anybody who sets themselves up to give advice in respect of crisis pregnancies cannot give false advice and must adhere to certain standards and codes of practice.

We recognise the points the Minister made - he made them well - about the various structural difficulties that would have to be overcome to regulate any profession. We welcome the fact that he has said he is willing to work with Deputy Howlin and the party and other interested Members because they are seriously concerned about this issue as well. We also welcome the fact that the Minister indicated that he will review the Regulation of Information (Services outside the State for Termination of Pregnancies) Act 1995 as part of his response in addressing the concerns that have arisen. As Deputy Howlin pointed out, this Bill concerns “act information”, the very precise information about where a woman can go in Britain. It is not the broader kind of information that women often look for when they are initially faced with the shock of being pregnant when they did not expect to be. While we welcome the review the Minister has announced, our Bill addresses the broader issues of information.

I also thank the various bodies which have assisted us, including the Irish Family Planning Association, IFPA. There has been a need to address this for a long time. The two journalists who exposed what was going on brought the matter to public attention. I commend Sinead Ahern, who went undercover and managed to expose what was happening. This was done because of a genuine concern that we do not want any woman to have to go through this or be given that kind of false information. Different opinions will probably be expressed in this debate in the context of the general issues of repealing the eighth amendment and people’s views on abortion. I, too, would stress that even if the false information was going to direct a woman the other way, it should not be given to her. Nobody should be given false information, whatever the motivation for it. The information has to be factual and true.

I welcome that we openly debate these issues regularly. We have had debates in this House about the repeal of the eighth amendment and the need to have a referendum. There was a time when it was extremely difficult to debate any of these issues in any kind of logical or non-abusive way. I well remember in 1983 and 1995, when some very nasty and vindictive people abused those who argued the case for the right to travel and to have accurate information. We have matured as a society in the way we debate these issues and that is to be welcomed. I hope that when we get to debate the repeal of the eighth amendment, after the Citizens' Assembly makes its recommendations, we will have a civilised and respectful debate. I would be surprised if Members oppose the Second Stage of this Bill because it only seeks to ensure that information is accurate. It does not seek to change people’s views on the substantive issue. It is very specific about the giving of accurate information and the outlawing of rogue agencies set up to mislead because of the points of view of those who established them.

I hope that people on all sides, of whatever view, will support the legislation we are putting forward. We want to list crisis pregnancy agencies in the primary legislation to ensure that we can have action as quickly as possible on this issue in order that, in the immediate or near future, no woman will be placed in the situation Deputy Burton described of being met in a car park, or anywhere else, and given inaccurate information when she is at a particularly vulnerable time in her life and making a very big decision. I hope that Members on all sides will support this Bill.

I fully support the need for women always to receive factual information when receiving counselling in a crisis pregnancy situation. I do not believe there is a single person in this House who would disagree with that. However, I have to raise concerns about the motivation behind the legislation being put forward today. The proposed legislation cannot be discussed without looking at the background that led to today’s move. It is very clear that the sole motivation for this amendment was a newspaper report about a certain anti-abortion agency. It is impossible not to notice the double standards at play here and the way the Minister for Health and those putting forward today’s amendment ignored the outrageous behaviour and counselling practices at the Irish Family Planning Association, IFPA, clinics. In 2012, IFPA counsellors were found to be telling women they could lie to their doctors and say they had a miscarriage, and not an abortion, if complications arose after their abortion. I find it very hard to understand why the Minister for Health has never condemned this scandalous and dangerous advice that was given to women, which put their lives at risk. To think that the same agency advised women on how to illegally import abortion pills to consume without any medical supervision adds to this terrible scandal. The fact is that the IFPA receives State funding, but the anti-abortion agency that motivated the debate here today does not receive any such funding. Surely there is something amiss when the Minister for Health sits back and does nothing when a State-funded body is found to be engaging in such reckless behaviour. It is important that we keep all this in mind when the current discussion is under way. The public deplore double standards and rightly so. I would have no difficulty supporting changes to make counselling safer for women but I have well-based concerns about the reasons behind today’s proposed changes. There is nothing fair and objective about targeting one side of this debate while turning a blind eye to the extreme wrongdoings on the other side.

We are not targeting sides.

Let us be very clear. That is what is happening here today and I regret to have to say it. Even at this late stage, I call on the Minister for Health to condemn what the IFPA has done and to call on it to provide a full explanation for its wrongdoings. Failure to do so leaves the Minister open to the charges of bias and double standards.

I am delighted to be able to speak and I am glad that the Minister is here for the debate. In November 2012, undercover investigators revealed that the IFPA clinics and other clinics that are overseen and funded by the HSE’s crisis pregnancy programme were involved in actively encouraging women in crisis pregnancies to mislead and lie to their doctors about their abortions if complications were to arise after the abortion procedure. That is a fact. The advice was described at the time as reckless and dangerous. Deputy Burton was a Minister at that time and later became Tánaiste. She did not have any problem with it at that time even though I called several times a year for an investigation. When the investigation became public, Dr. Sam Coulter Smith, not me, said that he was aware of cases in which women had died because they did not tell their doctors they had an abortion. That is also very serious. It is disturbing that such poor advice would be given to Irish women in crisis pregnancies at such a difficult time. At least Deputy Jan O'Sullivan stated here tonight that the advice from the other side was also wrong, dangerous and reckless. She is the only person to have acknowledged that so far, including the Minister.

I do not think she said that.

The finding was just one of a number of disturbing findings revealed in the investigation. It also found the IFPA in particular was in breach of several provisions of the abortion information Act 1995, which I do not think the Minister mentioned tonight, though he mentioned other Acts. It appears this legislation was being breached on a wide-scale basis. This reflected a high level of contempt for the health and wellbeing of the women, not to mention the law of the land. Following on from this investigation, a so-called independent inquiry was established at the time by the HSE boss, Mr. Tony O’Brien, who is also the former head of the IFPA. The inquiry was to be chaired by Ms Brigid McManus, a former Secretary General of the Department of Education and Science.

However, in reply to parliamentary question from the former Deputy, Terence Flanagan, the impression was given that the investigation and inquiry has been downgraded to an audit, which is something entirely different. I raised that in the House countless times with the Taoiseach and then Tánaiste, Deputy Eamon Gilmore, and later on, then Tánaiste, Deputy Burton. The inquiry was established in November 2012 and seven months later no significant progress had been made. I asked the then Tánaiste, Deputy Gilmore, to explain the delay in the investigation given the seriousness of the wrongdoing, which all Deputies are talking about tonight. It is very serious and very wrong to be giving that kind of dangerous advice given the seriousness of the situation.

The undercover investigation had revealed that women’s health was being endangered. It is funny how investigations are picked. All investigations are very important and right. We must condemn, and must have legislation for, any wrong information being giving by anybody on any side. Why was the investigation downgraded to an audit? Were the people giving this dangerous information suspended? They should have been suspended, or at the very least, some action should have been taken. Was any part of the €3 million in HSE funding to the offending agencies withdrawn or withheld? Goodness knows, we need HSE funding for a lot of things. If not, why not? Why is the IFPA, a State-funded agency, which has given out life-endangering and inaccurate information to vulnerable women and girls in crisis pregnancies, still receiving money when other HSE programmes are being targeted and seriously cut? I wish the Minister, Deputy Harris, well in his new portfolio and I still wish him well.

I thank the Deputy.

Even at this late stage, I call on the Minister, a new Minister with no baggage coming into this portfolio, to condemn what has come to light regarding the abuses that have taken place in IFPA-run counselling centres. He was well able to use very strong words on the other side of the equation tonight and rightly so. Surely he has to have some bit of moral standing in the other area as well. Some passing remark about general concern regarding poor standards in counselling provision will not suffice. The Minister for Health owes it to women who received nothing short of life-endangering advice from the IFPA to condemn in the strongest possible terms what the IFPA did and to commit to looking most closely at what has gone on in IFPA centres. He did condemn the other side very robustly.

I propose a further amendment to this Bill to ensure that pregnancy counselling agencies cannot be involved in political campaigning. That is very important and nobody on any side of the House has referred to this. The difficulty arises in framing the law to rule out the possibility of groups like the IFPA campaigning for changes to the Constitution, including repeal of the eighth amendment, while also supposedly acting as impartial counselling providers. That cannot happen. Again, I wholeheartedly support the idea of fact-based impartial counselling. That is vital. However, there is a breathtaking hypocrisy and double standard behind today’s proposal which is clearly motivated by a desire to single out anti-abortion groups, while giving a complete and unjustified clean bill of health to radical pro-choice groups. The fact that the Minister for Health or his predecessor have never publicly criticised what went on at the IFPA sums up everything I am saying. It is not too late for the Minister, Deputy Harris, to do so. The public is waiting for him to correct his view and his very clear lapse and omission. He used very strong and extreme words here this evening such as "repulsive", "shameless", "despicable" and "disgusting".

It was equally repulsive, shameless, despicable and disgusting when the other advice was given out by HSE-funded people. The Minister never said a word about that. The Minister's future career is on the line. If he wants to be honest and straightforward with people, by all means he should, but he cannot have such naked double standards.

I wholeheartedly support the idea of best practice being followed at all times by those offering counselling. The proposed legislation is coming from a former Minister, Deputy Howlin, who was one of the top four or magnificent four in the previous Government. He ignored appeals by me, by the former Deputy, Terence Flanagan, and others during his time in government to carry out that investigation and stop it from being downgraded to an audit. There was nothing done. He blatantly ignored it and so did the two iar-Thánaistí, Deputies Gilmore and Burton. They ignored it. For them to come in here this evening with this motion is sickening and it is so hypocritical to have to listen to this kind of double standards a short time after. They think we are all going to forget about it and go away. Thankfully, some of us have not gone away, you know.

The Labour Party's proposed change to the law is directly linked to one particular undercover operation, which I welcome, that focused on an exposé of an anti-abortion counselling agency. As I said, Deputy Howlin ignored all of the other ones. It just does not add up. How come no similar concerns or rushes to change the law were raised by the Labour Party when many of us on this side of the House showed that the State-funded IFPA was giving women life-endangering advice during crisis pregnancy counselling? Where was the outrage and calls for changes to the law from the Labour Party then? The party was in government. It could have drafted a Bill any day it wanted to. Where was the outrage when the IFPA was caught on tape telling women to lie to their doctors, as Deputy Collins said, and to say they had a miscarriage and not an abortion in the event of medical complications arising. Goodness knows, many can arise. I have heard the Minister for Health voice his support for this proposal on the radio a few times. It is impossible to take Deputy Howlin’s proposal, or the Minister's support for it, seriously when both men have maintained absolute silence about the life-endangering abuses of the IFPA counselling.

The people out there are not fools altogether. They are educated, both young and old. They know what is going on. They can recognise downright lies. Lies were mentioned so many times tonight. I thought it was not allowed to mention them in this Chamber but downright lies have been quoted several times by proponents of the Bill. Damn lies. Many people are rightly revolted by the unbelievable hypocritical-----

The Deputy cannot accuse somebody of telling lies.

No, I am not, but lies have been quoted.

I am not. I said lies have been quoted a dozen times already.

I know, but the Deputy cannot accuse anyone of telling lies.

I am not accusing anyone, I am just saying other speakers referred to lies.

The Deputy cannot use the word "lies".

They can blame God if they like. The Minister quoted lies several times and so did Deputy Burton.


It is a one-sided affair.

You are wasting my time, Acting Chairman.

I do not want to interrupt Deputy McGrath but-----

Many people are rightly revolted by the unbelievable hypocritical double standards of both men, but it is worse when it comes from the women. The Minister has made many comments about hypocrisy and words. I challenge him to correct the record and try to ensure there is some modicum of fair play.


Could I continue? I did not interrupt anyone.

Deputy McGrath can of course, but he should not mention lies.

How much time do I have left?

The Deputy has 1.07 minutes left.


I do not need any chorus of support at all. I am fine.

A total of 1.07 minutes is left. Time is running out.

I welcome what the Minister said about fitness to practise and all the regimes he will bring in and about addressing the failure to adhere to the code of practice. That is all very serious. I wholeheartedly welcome them. They have to be there and they exist in certain areas.

If I heard the Minister correctly he said the consultation started on 31 August and the closing date is 30 November. How many people know that or is it only the professionals that will be involved in the consultation?

It is for the public.

Could the Minister elaborate on that and clarify the situation for me? Wherever wrongdoing exists it must be addressed. All health care professionals must adhere to a fitness to practise code. That operates across the board. We have seen so many cases where that did not happen. I am very disappointed with the Minister's speech tonight. It was obviously well prepared by his officials and himself - I do not say the Minister could not do it - but I am unhappy that he ignored the previous investigation and the fact that the HSE-sponsored funding from taxpayers was used, which is needed for knee operations, cataract operations and other operations. The Minister knows the situation. He visited Clonmel and he met the carers and saw the bedlam. The Minister ignored the squandering of that money to give illegal, dangerous, life-threatening advice to young pregnant women and he continues to do so, as has the proposer of the Bill.

We cannot do this - just close a chapter in a book from the previous Dáil and introduce it in this Dáil. Deputy Harris is the new Minister and it behoves him to be honest with the people, be honest with himself and true to himself and the unfortunate people. The Minister said he met women, and I believe he did. I know he is a compassionate man. Will he meet the group of women known as Women Hurt by Abortion? The Minister said he wants to meet people on all sides of the debate. The group was not allowed into the hearings in 2013. Will the Minister meet the group, whose members will be very calm in telling him their story? It is very important to have all the knowledge and the full facts. I look forward to debating the issue further and to opposing the Second Stage reading.

Fianna Fáil will support the Bill, the purpose of which was outlined by Deputy Howlin who sponsored it and which was further elaborated on by the Minister for Health, Deputy Harris. The issue gives rise to emotive debate but at the same time we have an obligation to ensure that health and social care professionals and counsellors in the area of crisis pregnancy are imparting ethical, factual, clinical information that is truthful and objective. Regardless of the position one takes on the argument, the purpose of the Bill is to take no sides but to ensure there is an obligation on counsellors to give factual information based on clinical practice and empirical evidence. That is no more or less than the Bill proposes.

The Minister, Deputy Harris, outlined that there are some deficiencies in the Bill and that departmental officials will be made available for discussion with Deputy Howlin and others who wish to play a proactive role in trying to ensure that information imparted to women who are in a very vulnerable state is factual and objective and that there is no sleight of hand in terms of the advice being given to them. The purpose of the Bill is tangible and is required.

There is no doubt that in recent years we have seen some groups give advice in clinics in a negative way and journalists have uncovered damaging information being imparted to women at a time of crisis. I compliment the investigative journalists who went under cover and highlighted this issue. It is completely unacceptable for advice to be given to people that is wholly inaccurate without clinical or medical support or evidential base. For that reason the Bill will start a debate and a process to ensure we get to a position where formal governance structures and regulation are in place for such counselling.

The Minister announced tonight that in tandem with the consideration of the Bill his Department is commencing a review of the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995 as part of the response to addressing the concerns that have arisen. I hope whichever route is taken that the process will be speedy and that it does not fall between the two possible approaches we can take, namely the legislative review or the Bill proposed by Deputy Howlin.

We have had debates in this House previously on other health care professionals. It is important that there is absolute confidence in the regulatory authorities that oversee the various health care professionals. Those that are currently governed by the Health and Social Care Professions Act were outlined and Deputy Howlin proposes to include crisis pregnancy counsellors as well. There is no doubt about the significant difficulty in regulating this sector because of the grandfathering obligations that might exist and the fact that some groups are completely outside the regulatory system in terms of self-governance and self-regulation. Much work remains to be done on the issue. If the Minister is to make his officials available I ask that time would then be made available in Parliament to progress the issue and to have the legislation passed.

I support the principle of the Bill and I urge everyone to support it to ensure there is integrity in the counselling system and confidence that counsellors are imparting information that is accurate, objective, truthful, that can be clinically substantiated and that they do not try to direct a woman in a crisis pregnancy one way or the other. The information should be given and the choice made by the woman herself, her family, her clinician and others that might be involved in the decision-making process as well. I welcome the opportunity to speak on the Bill and I hope it can progress in a reasonable timeframe. I hope it does not fall between two stools due to the fact the Minister, Deputy Harris, has also said he will review in tandem the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995.

Before I call Deputy Bríd Smith I wish to advise that we have 51 minutes left and five speakers remaining plus the Minister for five minutes and the proposer for ten minutes. I will try to get everybody in and ask people to assist. I will call on them after seven minutes.

I will concede five minutes of my time if that helps.

All right. I thank Deputy Howlin very much.

I do not think I will take much more than the seven minutes. We have spoken a lot about this issue in this House.

I sure have and I will continue to do so. First, I very much welcome the discussion because I do not think we can talk about this enough because every day that goes by another 12 women leave this country to procure an abortion, and another three at least procure the abortion pill. The reality behind women’s lives, fatal foetal abnormality tragedies and other related issues continues as we continue to fail to deal with this issue.

I welcome the opportunity to discuss it.

I am amazed at Deputy Mattie McGrath. He has been a Member of the House a long time, but the arguments he made were so unscientific, silly, prejudiced and bigoted. They appeared to have been dragged up from a period Ireland had gone through and forgotten. On what he said about the Irish Family Planning Association, I remember it very well. The so-called pro-life people who were actually anti-choice - if they were pro-life, they would care about the deaths of women but they do not - deliberately targeted the Irish Family Planning Association, picketed its clinics and tried to have it criminalised for giving false information. They were found to have a false perception. I remember it because I took part in a counter picket on Cathal Brugha Street with people to whom Deputy Mattie McGrath referred to as women who had been hurt by abortion.

We should not frame this discussion in terms of the fear of the horrible things that happen to women after they have an abortion or that they cannot go back to their doctor because they have to hide it. The fact is that abortion is a reality in this country and we should not scapegoat women. I believe there was a day in this Parliament, although I was not around at the time - Deputy Mattie McGrath might have been here - when women who advocated repealing the eighth amendment or stood up for the right to choose were called murderers. Thank God, we have moved on and that is my point. We have moved on from the level of debate in which Deputy Mattie McGrath engaged because Irish society has moved on in a huge way and we now have to think carefully about what the reality is.

The Bill tries to address the disgraceful situation where a State-funded clinic gave information. Some of it is difficult to repeat, but one woman was told that she could not have an abortion before eight weeks of gestation because if she were to have one any earlier, there would be too much of a danger of leaving a body part behind because the foetus was so small. She was told she might still be pregnant if a body part was left behind. What ugly, unscientific, anti-medical, anti-logic crap is that to be spewing out. Whatever the Irish Family Planning Association might have told women, it certainly was not anti-medical. I know hundreds of women who, like me, would have been in dire straits without the services of the association and very much appreciated its support and advice during the country's dark years when to even say the word "abortion" would almost have resulted in a crucifix and a piece of garlic being put in front of someone because he or she was some kind of devil.

The regulation of access to information on services legally available in other states is what this discussion is about. How do we regulate access to information available in other states? One would not find this in any other aspect of life or any other jurisdiction. The services about which we are talking regulating are available in other states and we are looking at how we regulate the information on them. It speaks volumes about the country that such detailed regulations and guidelines are required to spell out to women how and where they can find information on ways and means of controlling their bodily autonomy.

In one way I echo what Deputy Mattie McGrath said. What guarantee do we have that the State did not fund or will in the future fund agencies that have existed for a long time? The one on Berkeley Street, which has been referred to, set itself up under various names since 2000 and at one stage advertised itself as offering advice on British options available for pregnant women, emphasising repeatedly that it focused on the truth about abortion. One can say all of these things and tick the boxes in the regulation, but does that mean that we now have to have a regulatory authority with inspectors to oversee it or from time to time send women undercover for interviews to make sure it is not happening?

It is the failure of the House to deal with the question of abortion rights for many decades that has brought us to this point. We would not be discussing the Bill had we agreed to hold a referendum to repeal the eighth amendment. We could be in a more clear-cut, uncomplicated and better place for the women of today and of the future had we agreed to put the question to the people whether they wanted to repeal or retain the eighth amendment. The eighth amendment lies behind all of the issues about services abroad and the information available on them, etc. God knows, they were dark days when Cosmopolitan had to import its version of a magazine into this country with blank spots throughout covering advertisements for abortion services. A book entitled Everywoman was removed from every shelf in every public library in the country because it told women that they might be able to procure an abortion. It was not only the publication of books and magazines that was affected. The Trinity College Students' Union was taken through the courts because it had provided students with the names and addresses of clinics. We should move on and get away from that anti-scientific, scary argument and start thinking about what needs to be done very quickly to end this draconian law.

I welcome the discussion and congratulate Deputy Brendan Howlin on introducing the Bill. It is a pity that when his party was in power, it did not manage to have the eighth amendment repealed or vote in favour of the Bill on fatal foetal abnormalities Bill but such is life. People change and move on. Thankfully, we are moving on.

I want to start my contribution by expressing my support for the Irish Family Planning Association and the work it does. Unfortunately, Deputy Mattie McGrath has just exited the Chamber. He is a little like a rogue agency spewing out an awful lot of nonsense. We have all seen the leaflets, some of which are to be found in community centres, which ask: "Pregnant and scared? Do you need help? Are you confused? We are here to help you." When women are faced with a crisis pregnancy, they become desperate for help and to seek allies. Unfortunately, as alluded to by Deputy Bríd Smith, because of our point blank refusal to tackle the issue of repealing the eighth amendment, the subject of terminations and the advice available to women remains underground. It is seen as sordid and seedy, but that should not be the case. Women should have access to the information they need.

The agencies and counsellors the Bill seeks to regulate effectively prey on vulnerable women. They seek out women who find themselves in a desperate situation and attack them. They need to be tackled, regulated and put out of business. Somebody recently sent me a copy of a leaflet from an organisation that purported to have a cure for cancer. Clearly, it does not, but if a family member has cancer and someone is desperate, he or she might telephone that number or call to that clinic. We have a job of work to do to regulate all of the agencies that offer what they call simple solutions to the problems people in vulnerable situations face. Some of the leaflets on the websites of the rogue agencies include very damaging, violent and disgusting language. They state abortion has been associated with emotional and psychological impacts. They list the symptoms as including guilt, depression, suicidal thoughts, difficulty in bonding with one's partner or children and eating disorders. The most recent leaflet exposed relies on a disproved connection between abortion and breast cancer. None of these claims has any basis in scientific fact.

The organisations in question have a clear hidden agenda. They attract desperate, vulnerable women in order that they can pressure them into making one decision or stigmatise them because of a decision they might have already made. Rather than offer legitimate counselling or impartial advice to the vulnerable women concerned, they delay the counselling process and, in certain cases, show clients inappropriate images and use falsified health and scientific warnings to influence their decision.

How they operate is shameful. It is happening less than a kilometre away from our door and something definitely needs to be done.

A reputable service, such as the service provided by the Irish Family Planning Association, will counsel women on all of the available options and will not try to persuade, cajole or strong-arm a woman into making a choice. It will simply provide her with information.

Regrettably, the revelations about rogue agencies are not new. If one simply types the issue into Google, one can see that there have been several exposés. In 2007, Hot Press ran an article on this issue. It had a copy of a recording with a counsellor from one of these agencies. That was ten years ago. In that recording, much like the one from 2016, the "counsellor", which term I use advisedly, repeatedly told the lie that abortion causes breast cancer, stating:

Your risk of breast cancer rises significantly ... every woman who has an abortion her risk of breast cancer rises ... you're the one that's going to have to go away and get up in the stirrups and risk breast cancer which is already in your family. ... if you decide to continue with the pregnancy you'll have protected yourself for life from breast cancer.

This is to a vulnerable woman, a woman who is desperate and who wants to know what her options are. She gets told that one of her options will definitely cause breast cancer. That is shameful. We know what is out there.

I thank Ms Ellen Coyne and the team in The Times for the exposé. It is welcome, but it is not new. We know that it is there. Like Deputy Bríd Smith, I also wonder why action was not taken on this while the proposers were in government but it was not and we are where we are. Therefore, it behoves us to support this legislation. I personally am not convinced that it will do all that it is intended to do but I welcome the fact there is cross-party support. It means we will have an opportunity on Committee Stage to look at it in detail and ensure that whatever arises out of our deliberations is fit for purpose and puts an end to it. There is broad agreement that we need to put an end to the rogue agencies that are operating.

These agencies, of course, are a last port of call for women. They should not be allowed to operate. A woman should know when she needs help that she can pick up the phone or make an appointment, that she will be counselled on all of the options that are available to her, that she will not be judged and that she will not be made to feel worse than she already does.

As I said, my party will be supporting this Bill, and we are happy to do so. I would also like to put on record our willingness to engage with all of the parties, and to take up the Minister on his offer to engage with the officials in his Department to ensure our collective goal in this regard to put these agencies out of business.

This Bill will bring the crisis pregnancy counsellors under some form of regulation and will allow for some kind of monitoring and complaints process but we need to be absolutely certain that it will stop people from disseminating misinformation or selectively highlighting what they term to be medical risks. This legislation is well-intentioned and I sincerely hope it does not have the impact of forcing reputable counsellors and counselling agencies into a regulatory framework while the ones we seek to regulate can change their name or go underground to remain outside of that. With cross-party support, if we put our heads together, we can ensure that does not happen. I very much look forward to the cross-party engagement on this legislation. When it comes to the next stage, as I said, my party will be supporting this and we are hopeful that we will be able to develop comprehensive legislation which ensures that we do not have to read any more of those exposés.

If I could, I will use my last few remaining seconds to reiterate my support for the Irish Family Planning Association and to reject the claims made by Deputy Mattie McGrath. The association does good work and that would not be disputed by the vast majority of Members in this Chamber.

The Anti-Austerity Alliance supports any attempt, including this Bill, to legislate for rogue crisis pregnancy agencies. The purpose of such agencies is not to help women. Their sole purpose is to prevent women from having abortions and to use any lies and intimidation they possibly can. These agencies are generally staffed by anti-choice volunteers, although there is a trend of late to employ medical staff, and even to use ultrasounds - to show women ultrasounds and try to use medical science to frighten women.

The key words these agencies use in the advertising of their services on the Internet are, for instance, "Scared" and "Family planning" to fool people. Obviously, many and probably most of the women who contact them in the first place are seeking to get information about abortion, at least as one of the options and, if not, they have already made up their mind. They generally pop up as the first item in any search engine, if one googles "crisis pregnancy". They even use terms like "abortion information", as a way to get click bait and get people to look for them, and often they locate near counselling centres to fool people, using names such as "reproductive choices", which is obviously completely the opposite of what they stand for. They prey on the most vulnerable - women who are the least likely to be able to pay for or access information. As has been said, usually what they do is cause a delay in the woman seeking an abortion, leading to later abortions in many cases. The stories have already been well told here tonight about the myths that they perpetuate, that abortion leads to breast cancer, it leads one to abusing children in the future etc. and therefore I do not need to spend too much time on that.

The Minister has agreed to support the Bill but one point that really struck me in the course of his contribution, which I googled during the rest of the debate, is that he tells us there is legislation in place to tackle rogue crisis pregnancy agencies. He talked about what is known as the 1995 abortion information Act, the full name of which is Regulation of Information (Services Outside the State For Termination of Pregnancies) Act 1995, which was obviously brought in following the X case. I checked it out. In section 5(b)(iii), if one gives information or counselling to anyone who is pregnant who is seeking information and if it is inaccurate and not objective, one can be taken to court. I would ask the Minister why is he not doing so then? If he is telling us that there is something in statute, how many persons have been prosecuted in the past 21 years under this Act? I would like the Minister to come back and answer that because it is outrageous that this has been going on for nearly a quarter of a century and yet nothing has been done about it. Why are these clinics not being shut down on the basis of that Act? Do we even need this Bill? The Minister needs to explain why that Act has not been invoked despite him expressing concerns when this all came out and the story was broken by those investigative journalists.

The elephant in the room here is that we should not be meeting late tonight to discuss this in the first place. The only reason we are having this discussion is that we have the eighth amendment, which bars not only abortion but information about abortion and makes it extremely difficult for women to get that information.

I am absolutely gobsmacked. Deputies Michael Collins and Mattie McGrath - I was going to say "Deputies Trump" - find it surprising that a woman might go to her doctor and not tell that she has had an abortion. What planet are they living in? It is because of people like them that women have to do that, that a woman cannot be honest with her own doctor because there is a 14-year jail sentence. Abortion is a criminal offence. Lots of women do not tell doctors that they have had abortions and I am surprised that they are surprised about that.

In relation to the allegation Deputy Michael Collins, who is from Cork, made, one would think women from Cork and Tipperary never had abortions. Of course, they do.

Deputy Michael Collins referred to abortion pills without medical supervision. That is because women cannot get medical supervision. The pills are illegal precisely because of people like him.

With regard to the Irish Family Planning Association, IFPA, I would be very surprised if it told women to tell lies to their doctors. My knowledge of the association is that it sticks very much to the letter of the law. I have criticised the association in the case of the migrant rape victim. She was attending the association for months for counselling. That poor girl, who was effectively tortured in this country, should have been given, or at least been directed to, safe but illegal abortion pills if she wanted them, or at least told about the website. I am sure the association did not do that because it was afraid, so I would be surprised if it was giving inaccurate information.

I wish to comment on the likes of Deputy Mattie McGrath. He said that lies are worse when they are told by women. I am not sure what he meant by that, but I will tell him the truth now. He is a sexist, backward man with an inordinate interest in women's bodies. That is the unvarnished truth. There is something very distasteful about older men lecturing younger women, who are generally affected by these issues, in such a way. It must be said. This is something that will never affect them, yet they are judging and talking about women in this way.

I wish to point to some items that could potentially be added to the Bill. One of the dangers with the Bill, and it is not a danger with the proposers of the Bill, is that I hope it is not just a way to avoid dealing with the abortion issue and abortion information in Ireland. We must have a situation where the eighth amendment is repealed and abortion is fully decriminalised. The reason women are skulking around back alleys looking for information is that they cannot get it. Once abortion is criminalised there is a penalty attached to helping somebody to get one. What is even more disgraceful is that it is illegal to give women information on how to access safe legal abortion in England outside of a one-to-one counselling session. That is the situation in this country. However, it is perfectly legal for religious fundamentalists, which is effectively what they are, and the ghouls who prey on women in these rogue agencies to tell women with crisis pregnancies a pack of lies. No legal action is taken against them, yet one cannot give somebody information on how to access a safe abortion.

Another addition that could be made, and the Anti-Austerity Alliance would be willing to table such an amendment, is to add sex educators to the potential list. I will outline the reason. At present, agencies such as Life Pregnancy Care and Family & Life are going into schools and giving precisely the same information to young children. In 2014 an investigation by The Irish Times found that students were being given sex education in schools by teachers and outside agencies such as those I mentioned. In those lessons students were told that abortion damages a woman's internal organs and it destroys a woman's mental health. They were also told that a woman who has an abortion might feel she is being punished if she suffers a miscarriage in a later pregnancy. The third piece of information was that women can feel suicidal and might harm themselves after having an abortion. The fourth piece was that life begins at the moment of conception, which is not something most people in this country believe. Otherwise, they would not support morning-after contraception. It is something a small group of religious people believe. The students were also told that the most important person during pregnancy is the baby, so the woman receives no regard at all. This is what is being taught in schools at present. If we intend to close down rogue pregnancy counselling agencies, we should also shut down these agencies from infecting our children with this dangerous nonsense at an age when they are liable to be influenced and unable to challenge it. The Minister should consider that.

Finally, the Minister said that our women deserve more. They do deserve more. They deserve to have the right to have these services in their own country and not to have to skulk around Dorset Street or elsewhere, in fear and ignorance, seeking information. It is time for him to repeal the eighth amendment.

I thank Deputy Howlin and the other speakers for their contributions on this important issue. As the Minister, Deputy Harris, outlined, the Government is supporting the reading of the Bill for a second time but cautioning the House that much work will have to be done before it proceeds further. The Minister and the Government fully subscribe to the objective of the Bill, which is to protect the public. The Minister is committed to working with Deputy Howlin and other Members to arrive at more workable solutions to ensure that truthful and objective information is made available to all women experiencing crisis pregnancies.

We all agree that a woman seeking advice on a crisis pregnancy must be provided with truthful and objective information, and that it is appropriate that the State facilitates its provision. Women can currently seek such information in the context of free and non-judgmental counselling through Positive Options, the crisis pregnancy service that is funded and overseen by the Health Service Executive. People with concerns about the veracity with which they have been dealt with by service providers can have their concerns investigated by the Garda under the Regulation of Information (Services Outside the State for Termination of Pregnancies) Act 1995, but there may be a need to strengthen these provisions and to create greater awareness of this legislation. Deputy Coppinger referred to this and we can establish if complaints have been made to An Garda Síochána through the Department of Justice and Equality. The Minister has asked the Department to commence a review of the Act, as he announced this evening.

The bringing of counsellors within the ambit of the Health and Social Care Professionals Act 2005 will also provide better protection of the public and should go a long way towards addressing Deputy Howlin’s genuine concerns. The Act provides that only registrants are entitled to use the protected title. A person who is not registered and who uses a title protected under the Act would be guilty of an offence and would be liable on prosecution to a class A fine or up to six months in prison or both. Registrants are also subject to the Act's fitness to practice regime. This allows for complaints about the conduct or competence of registrants to be investigated. Disciplinary sanctions, where complaints are substantiated, up to and including cancellation of registration, may be imposed. The regime is similar to that applicable to medical practitioners, nurses and midwives. The Minister's proposals to regulate counsellors under the Act are currently out for public consultation and he hopes to be in a position to submit draft regulations to this House next year.

While I support the Bill before the House, a particular concern we have with it is that it would treat pregnancy counsellors separately from counsellors generally and would regulate them differently from the fourteen other professions currently designated under the Act. This in turn would pose difficulties for the operation of the 2005 Act into the future. It is the Minister's intention to make progress through utilising both the forthcoming registration of counsellors and the existing regulation of information Act 1995 to result in a more workable solution to the challenge of ensuring that truthful and objective information is made available to all women experiencing crisis pregnancies.

For these reasons, I support the Minister's proposal that the Bill be read a second time but I join him in pointing to the additional work that will be required before the Bill proceeds further.

I thank the Deputies who contributed to the debate. Newer Deputies might not be aware that sometimes we have not had the opportunity to have the type of open debate on the abortion issue as is possible in this Dáil. Much reference has been made to the information legislation that was brought to the House by the then Minister, Deputy Michael Noonan. I drafted that legislation in 1994 when I was Minister for Health. At the time, my office in Wexford was picketed for three weeks by Youth Defence. On one Saturday its members put posters on every storefront on Main Street stating that "Howlin murders babies". That was the atmosphere of the 1990s.

It was the atmosphere of the debate we had when the original eighth amendment was proposed in the 1980s. We have come a very long way. There are only two Oireachtas Members still here who voted against the original amendment in 1983, namely, me and, as far as I remember, the Minister, Deputy Shane Ross, who was a Member of the Seanad, as I was, at the time. The atmosphere was poisonous. There was no objective debate on it. Although we have moved a long way from it, there is still potential for a poisonous debate on it, and we need to anchor ourselves in calmness as best we can. We must allow people who have genuine concerns, whatever their perspective, to be heard but at the same time anchor ourselves in objective fact. Objective fact is becoming a scarce commodity in political discourse generally, as we have seen in the conduct of the US presidential election.

The purpose of the Bill is straightforward, simple and unambiguous. It is to ensure whoever holds themselves out as counsellors in a crisis pregnancy would be required to be regulated in such a way that all the advice and information they impart must be truthful and accurate. I listened to Deputy Mattie McGrath passionately argue for the same principle and then conclude that he was going to oppose the Bill. There is no logic in that. If he believes, whatever perspective one brings, that one must tell the truth, he must support the Bill, given that this is what the Bill sets out to do.

There are two mechanisms under consideration, and we examined both of them. The first is the proposal we have before the House, using the Health and Social Care Professionals Act by adding to the list another category of health professional that would be required to be regulated, namely, pregnancy counsellors. I listened with care to the Minister's views. In all such matters there is always complexity. He proffered the view that the better alternative would be the Regulation of Information (Services Outside the State For Termination of Pregnancies) Act 1995 which Deputy Ruth Coppinger referenced. We examined the Act in some detail and the difficulty is that it applies only to "Act information", which is information relating to the procurement of an abortion. If a practitioner said he or she was not going to give any counselling relating to abortion, the information would not be "Act information" and could be as inaccurate, mischievous and damaging as one likes. The advice I received was that it was not the best vehicle to use. I imagine this is why there have not been prosecutions under the Act. It is related to dealing with the Supreme Court decision that giving information, even names and addresses, about places to have an abortion outside this jurisdiction was not tolerated under the eighth amendment. That was why we introduced the subsequent amendment on information and travel. I will happily work with the Minister for Health and his officials, by whatever means is open us, to arrive at our objective, which is to ensure women in this most vulnerable situation of crisis pregnancies or pregnancies they did not plan or want will have objective options put to them plainly, truthfully and accurately about what they need to do.

While I do not want to labour the point, I totally disagree with Deputy Mattie McGrath's totally unfair comments on the Irish Family Planning Association, IFPA, which over decades has provided an important service to women, men and families. I salute the IFPA and thank it for its work. Deputy Bríd Smith, in supporting the legislation, asked why we did not bring it forward earlier and said we should have done it previously. This is the first time anybody has done this. There was no consensus in Sinn Féin to repeal the eighth amendment until this Dáil. A significant portion of Sinn Féin would not have been in that category. Sinn Féin did nothing on the issue in the previous Dáil, and it had plenty of Private Members' time in which it could have done it. We should all come to this with a view that the thousands of women who find themselves pregnant when they do not want to be and who are worried and stressed need to be able to turn with confidence to those who hold themselves out to be counsellors and also need to know that whatever is told to them is the truth. They do not want to be horrified with lies and untruths.

It is a reasonable expectation that as we regulate chiropodists, podiatrists and dietitians, this category of medical advice should also be regulated. It is such an important decision that has lasting impacts on people's lives, and we must have regard to this. As my colleague, Deputy Joan Burton, said, it is not an extraordinarily complicated Bill. It is very straightforward and simply adds a new category to the list of professionals to be regulated. There is already a long list to be regulated, some of which are set out in the Act and others which have been added on under the Act by a decision of the Minister for Health. We have said it should be put directly into the Act, given that it is the quickest and most effective way of doing it. If there are difficulties with it or a more effective route to achieving the objective on which we have, by and large, a consensus or a majority view, I would be open to whatever route is best to achieve it. I look forward to working with all colleagues across all benches in the House to achieve the desired objective of the overwhelming majority of Dáil Members.

Question put and agreed to.