Dáil Éireann debate -
Thursday, 13 Jul 2023

Vol. 1042 No. 2

Health (Termination of Pregnancy Services) (Safe Access Zones) Bill 2023: Second Stage (Resumed)

Question again proposed: "That the Bill be now read a Second Time."

Deputy Réada Cronin

This is my second time speaking on this Bill and the third time the Bill has been before the Dáil. It has been shunted around the schedule. I acknowledge that the Minister for Health, Deputy Donnelly, is here. I appreciate that. I also take this opportunity to thank Together for Safety and my comrade in the Seanad, Senator Paul Gavan, who has been working on a similar safe access zones Bill that he drafted with Together for Safety in order to ensure that this matter stays in the public consciousness.

We repealed the eighth amendment. Women must be able to avail of abortion services as conveniently, particularly from a geographical point of view, as possible without strangers who should have no say in their lives and choices accosting them by insult or, more arrogantly, by prayer. To the men's prayer groups that are obstructing women's access to abortion care by prayer, I say that generations of women have spent long enough on their knees. We are up off them now. I recommend to these men that they get off their knees as well, get out of women's lives and stay out of them. If they will not listen to me, they might listen to Jesus, who told them in the gospels that if someone does not want to be a hypocrite, he or she should say his or her prayers at home. I recommend that these men go home, say their prayers and mind their own business.

It is a concern that swathes of the State are still without abortion services. I would like the Government to have gone further with the Bill. I believe fervently in the right to protest but decency must come into this. Nobody should be the subject of a protest when they are just going around and receiving whatever medical treatment they need. It is also a worry that while An Garda Síochána can make an arrest without warrant where they believe an offence has being committed in terms of this Bill, it also says it does not have an appropriate facility for recording offences. In effect, a person can have warnings at several locations if they are protesting but if these are not recorded, what action can follow? Will the Minister address that when he is replying? The Bill must be stronger in this recording regard because the practice is as important as the principle here.

Deputy Joan Collins

As we know, five years ago people in this country voted in overwhelming numbers to confirm that abortion services are a vital and legitimate part of women's healthcare. We voted to have abortion services seen under the law as a legitimate healthcare service provided by the State. To date, that democratic choice has not been realised with over 775 women having to travel to obtain abortion services in the UK since the referendum. The majority of these women travelled for health-related reasons.

I welcome the Bill as another step towards providing access to free, safe, legal, local abortion services for anybody who needs them. Abortion is healthcare; everyone has a right to it. Our current system does not go far enough to guarantee that right. The protests we have seen across the country have had a massive chilling effect on people's ability to get the healthcare they need. Like other Deputies, I received emails from people who are part of the Together for Safety campaign reporting regular protests outside University Maternity Hospital Limerick and the National Maternity Hospital, Holles Street, as well as reports of semi-regular protests at various medical centres around the country. I thank Karen and Yvie for the work they do on this and for reporting it. This does not just affect those availing of abortion services. No one should have to walk past protestors on their way to receive any sort of medical care. I am aware that some may have questions over this law with regards to civil liberties. However, ordinary women and healthcare workers are simply exercising their rights to give or receive the healthcare for which we voted in the referendum to repeal the eighth amendment.

I do not believe this Bill will overly restricts people's right to protest. People can protest all they want. They just cannot do it in a deliberate way that restricts people's right to the healthcare they need. It is the politicians here who wrote the existing laws, not the patients or workers in health clinics and hospitals. If anybody has a problem, they should be protesting outside the Dáil, not outside of our healthcare facilities.

In its submission to the Joint Committee on Health, the Irish Council of Civil Liberties, ICCL, stated the following with regard to human rights aspects of this Bill:

ICCL considers that demonstrations outside abortion providers designed to shame, harass, and deter women from accessing abortion care and deter service providers from providing such care pose a serious risk to a range of rights. These rights include the right to privacy, the right to bodily integrity, including the right to mental and physical health, and the right to access healthcare without discrimination. Anti-abortion demonstrations can also negatively affect the right of medical service providers to access their place of work safely. Evidence shows that the effect of anti-choice protests outside abortion clinics can have long lasting negative effects on a person’s health and well-being and can deter women from accessing the medical care they need.

I cannot sum it up better than that. I respect everyone's right to protest. I have protested all my life. I do not believe that right is overly affected by this Bill. Having to stand 100 m further away is fully proportionate to ensure the rights of everybody to receive the healthcare they need with privacy and dignity and without harm to their health or well-being. The same goes for healthcare workers' rights to do their jobs as well. We still have a way to go in this country before we can ensure proper access to abortion services for all.

Our current laws are woefully inadequate to provide abortion services properly. I welcome the Minister's comments in April to the effect that we will have all 19 maternity hospitals offering abortion services by early next year but we need reassurances on this. Will the Minister provide a timeline and confirm that all maternity hospitals will offer the full range of abortion and reproductive health services. I ask the Minister what he will do about the number of GPs offering services. Only one in ten GPs offers full reproductive healthcare. The independent review highlighted the fact that there was a very bad spread in the south east, with the west, the midlands and Border counties having clear regional disparities when it comes to services. Some 50% of counties have ten or fewer GPs who offer full reproductive healthcare. The independent review also highlights that we are not training or recruiting enough doctors. I agree there needs to be service maps to identify service gaps. Each year, more and more women travel to access abortion services abroad and each year more and more of these women suffer due to health reasons. I think the Minister will agree that this is not good enough. It shows a failure to follow through on the democratic choice the people of this country made in 2018. We need to make sure that no matter who someone is, no matter how much money or what visa status they have or where in the country they live, they have full access to abortion services when they need them. I hope we get the Health (Regulation of Termination of Pregnancy) (Amendment) Bill 2023 through the Houses as soon as possible in order that we can continue the work towards free, safe, legal, local abortion services and reproductive healthcare for all.

The mandatory three-day waiting period is identified in the report relating to this matter as a contentious issue. The report informs us that the position of the World Health Organization is that a mandatory waiting period should not be required and the evidence does not establish any benefit to mandatory waiting periods for women. The report cites the Unplanned Pregnancy and Abortion Care Study commissioned by the HSE, which showed that respondents wish to access care as quickly as possible and do not perceive any benefit to having the three-day waiting period for reflection on their decision. Respondents stated that they felt certain of their decision, had not taken their decision lightly and had reflected upon it prior to arranging an appointment with a GP or community provider. Research has found that the respondents were almost universally consistent on the portrayal of the three-day wait as having next to no impact on their decision.

I will make a final point. I echo the calls made during this debate to keep a register of offences by individuals across all safe access zones.

I will be supporting this Bill. I will also support any amendments designed to enhance it.

Deputy Thomas Pringle

There are a number of areas of consideration raised by the Health (Termination of Pregnancy Services) (Safe Access Zones) Bill 2023. On one hand, we have people who wish to exercise their freedom to protest. Within that, are freedom of assembly, freedom of association and freedom of expression. On the other hand, we have a legal healthcare service, the right to avail of that healthcare and also to the ability to safely provide this service. It is a balance of proportionality. I will fiercely protect the right to protest. It is a cornerstone of democratic society and a freedom we must all hold in deep regard. However, we live in complex and dynamic societies and communities. Within that, as we have seen time and time again in our courts, sometimes rights will compete. It is then the job of the judicial system or the Legislature to ensure that proportionality is applied in order that a balance may be struck. This Bill represents an attempt to do that.

As outlined in the European Convention on Human Rights guide to the freedom to protest, any interference with the right to freedom of association must pursue at least one of the legitimate aims set out in Article 11.2 of the convention, namely, national security or public safety, the prevention of disorder or crime, the protection of health and the protection of the rights and freedoms of others. A trial was conducted at a London clinic.

I do not know whether the Minister is aware of it, but there is a chapel in the National Maternity Hospital just across from us on Merrion Square, so it is a place of worship. The chapel is located in the building, since the hospital is one building. There is the exemption straight away. There is a church in the maternity hospital in Limerick where masses are said weekly, as they are in Holles Street. As such, it would appear that section 2(2) does not apply to either as the legislation is drafted. There is a church in St. Vincent's hospital, where the Government is proposing, if it ever gets around to it, to build a new national maternity hospital. This appears to be legislation that adds nothing to the Statute Book.

I wish to be clear in that I do not condone and I do condemn unequivocally anyone who seeks to intimidate someone who is accessing a medical facility for any purpose. Regardless of whether it is a purpose with which the former agrees or disagrees, he or she does not get to have that choice. People have a right to access medical facilities. I do not condone, and have no sympathy for, people who seek to intimidate or obstruct others going to such buildings. The legislation on our Statute Book already covers that clearly.

As regards disseminating information or merely praying, it must be proven that it is likely to change someone's mind and it has to regard a building where there is no public worship. There is public worship in all of the buildings I have mentioned. It is a nonsense, a waste of time and a tokenistic effort to be involved in some kind of a culture war that, thankfully, is unnecessary in this State as of now. For these reasons, I oppose the Bill.

Deputy Patrick Costello

Like many of the Deputies who have spoken, I welcome this legislation. It is something I have campaigned for and spoken about positively. I am happy to see the legislation coming through.

We must remember that, when it comes to accessing abortion services, it is important they be safe, local and legal. We had a strong campaign in this country to legalise abortion services and repeal the eighth amendment. I am glad that happened, and now here we are in a better place.

Safety includes being able to access healthcare provision, which is everyone's right without fear of intimidation or harassment. That safety is not just for the patients but for the staff who work there. Doctors, nurses and anyone else who works in healthcare facilities should be free to work or engage in those services free from harassment and intimidation. As such, any legislation we can introduce to protect their safety is important.

Turning to the issue of abortion services being available locally, the recent expert review highlighted the geographic gaps in service provision. There are concerns that the lack of protection is producing a chilling effect, with service providers unwilling to provide such services, thereby contributing to these gaps. We do not necessarily need to see the evidence of the protests, harassment and intimidation to know they are already having a chilling effect. We cannot monitor it, since that would essentially mean trying to prove a negative, but that effect is there and needs to be addressed so that we can ensure abortion services are available locally. I am happy the Bill will help to address this issue.

In dealing with the right to protest, we are in a way engaging in competing rights. We must keep in mind the classical test of proportionality. Are we trying to achieve a legitimate aim, does the legislation move us in the direction of achieving that aim and does it do so in the most minimal way possible? Clearly, it does. Access to healthcare is a right people have fought for and needs to be protected, and it is a legitimate aim for the State to want to provide these services. This legislation moves us towards protecting people, access and the staff delivering that service. Equally, it does so in a minimal way. The safe access zones are as minimal as they can be while still being effective. This is backed up strongly in the European Convention on Human Rights in terms of the balancing it has done between Article 10 and freedom of expression. The court has been clear that a person cannot use his or her rights to abuse or undermine the rights of someone else. We are seeking to protect access to healthcare in a way that is proportionate and minimal while still being effective.

Like other Deputies, I wish to address some of the other issues around the provision of abortion services to which we need to turn our attention. Many women are still forced to travel to the UK. This was something I had hoped would be part of our past, but we are still there. The three-day waiting period needs to be removed because it is a needless impediment. Another issue is the tightness of the 12-week limit, particularly in light of some of the reasons people have to make that independent but very difficult choice for themselves. Ultimately, it is about the individual’s right to choose. We need to address all of these issues. I hope the Minister, after achieving this aim, will move to do so.

This legislation is necessary. Given the reality of policing on the ground, police often want a clear, black-and-white offence. When it comes to things we want police to address, they will often put their hands up and say the law is confusing, too vague and unclear. Although it may be possible to cover something under another offence, this is why we still create specialist offences. In recent weeks, for example, there was new legislation before the House focusing on the spiking of drinks and non-fatal strangulation. Those were two areas where extra legislation was needed because, while they were covered by existing legislation, that legislation was still not strong enough to produce the effect we needed in terms of protecting individuals. With this Bill, we are simply providing clarity in legislation. While the issue may be covered in other places, that does not mean it is not needed. I would point to the chilling effect. Such matters show this is necessary legislation, not simply some importation of a culture war. I do not believe that is what is going on here, and I would reject that.

I commend the Minister and the legislation. It is great to have this legislation and to have protection for women who are accessing services they have the right to choose freely. I commend the Bill to the House.

Debate adjourned.