On a point of order, it is important that, having decided to sit tonight to take Committee Stage of this Bill we should be afforded as much time as is necessary to take it in as much detail as people wish. I rise to defend that principle. Having decided to take Committee Stage this evening, it is important that there be no curtailment of any kind on any amendments that may be put down.
Health (Family Planning) (Amendment) Bill, 1985: Committee Stage.
There was never any suggestion from this side of the House that there would be any curtailment of contributions even on Committee Stage. It is agreed that we will sit as long as is necessary to complete it. That is the agreement I reached with Fianna Fáil last week.
Senator Ferris is not correct about the agreements he states. Senator Ferris wanted all Stages of this Bill last week and I refused to give it.
Section 1 agreed to.
SECTION 2.
Question proposed: "That section 2 stand part of the Bill".
On section 2 (1) and the fact that there has been no discussion with the chemists and the medical profession, will the Minister comment on the conscience clause in Bills of this nature? There is not much activity in this regard at present under the 1979 Act, and is there a danger that this area will continue to be almost a non event? Paragraph III refers to health boards. The Midland Health Board at a special meeting almost unanimously took a firm decision not to support this Bill. This indicates that they want no hand act or part in the Bill. If that is so, how is it proposed in the Midland Health Board area to nominate a particular employee? Will the conscience clause operate for the employee nominated by them? Maybe other health boards have decided that they will not operate the Bill. What will the Minister do in that situation?
In my Second Stage contribution I asked the Minister if he would outline regulations governing the family planning clinics covered in section 2. I asked him if he would spell out to the House and for the public what standards family planning clinics would have to comply with. As I understand it family planning clinics must formally apply to the Minister and set down in their application the need in a particular area and must also convince the Minister that they achieve certain standards of advice, particularly medical advice. I understand that family planning clinics cannot function except under the supervision of a medical person. Will the Minister say whether what I say about the norms for a family planning clinic is correct? He might spell out for the House the form of application and what words are used in the agreements to allow anybody to open a family planning clinic.
Much has been said about family planning clinics. Certain accusations were made in the House tonight about various people and what they said about various other people. The Minister has been the subject of the most extraordinary criticism throughout the country, quite unfairly, particularly in this area of family planning clinics. He has been accused of opening illegal family planning clinics, but that is untrue. He has been accused continuously of advocating permissiveness, the free availability of contraceptives and so on. A fair deal of politics has been played on this issue. In the Minister's reply on section 2 will he put on the record of the House categorically the requirements for a family planning clinic and what type of professional advice should be available?
I have a number of issues I want to raise on section 2 of this Bill. I find myself somewhat handicapped in seeking to raise them because I had asked a number of questions on Second Stage which have not been replied to in the manner in which I would have liked in relation to providing this House with adequate information. I asked the Minister, who was present when I was speaking, for the full details of the investigation and report which he had initiated in the Department, and which I welcomed, into the whole operation of family planning services. We cannot fully, properly and conscientiously address ourselves to what is intended in section 2 of this Bill until we as elected representatives have the information which I have sought. For that reason I found myself unable to support a Government disciplinary measure of trying to rush this Bill through this evening. I regretted the fact, but I was prepared to accept it, there had been an agreement between this side of the House and the Fianna Fáil group that the Bill would be put through all Stages this evening. This is a very important Bill, a measure that should be given full debate. We should have time to reflect. We may have amendments in this House which would improve this Bill. We should be given a full opportunity to reflect on the Second Stage debate and on the numerous contributions that were made, to analyse and if we saw fit to come forward with amendments on Committee Stage. I was prepared to accept, because that is the reality of politics that a very unusual agreement has been entered into. It is not usual when a Bill is not urgent that all Stages of it would be taken on the one day, meaning the finalising of Second Stage, Committee and Final Stages. That is not the norm, and we have to remember this. It is abnormal and unusual, there must be a special reason for it.
We had a three-day debate.
Yes. A three-day debate on Second Stage.
And agreement, which the Senator was a party to.
I am party to but I was no party of. I heard about it later. I was told there was an agreement. That is as much party as I had to it and that is what one accepts. It is not unusual to be told there was an agreement. I was prepared to accept, reluctantly, that there was an agreement but in the event it transpires that the consent necessary to form the basis of an agreement had been withdrawn. There cannot be an agreement unless both parties agree. For the reasons advanced — I will not go into the merits of those reasons, I do not particularly subscribe to those reasons —the basis of the agreement had been withdrawn and therefore we had a vote on whether we would have a full debate on the Bill. I very much regret this because it implies that somehow the Government side are in the business of pushing the Bill through late at night. We are not in that business, we are now forced to be in that business. We are now going to try to have a genuine considered Committee Stage on the merits of the Bill. We are all tired, we have had a full day. I regret that I shall have to try to apply myself to Committee Stage debate on this Bill although I am not as fit or as prepared to do it as I would be next week, when it would be normal to take Committee Stage, because there are very important issues involved.
One of the matters we need to know more about in addressing ourselves to section 2 on Committee Stage is the full analysis which the Minister has embarked upon but which we are not privy to. That is something that I would like to have had in order to have a proper and informed Committee Stage debate, because we are seeking a reform in section 2, which I welcome. I would go further than that. I would either have no age limit at all or I would be quite happy with an age limit of 16 because I would face the realities of the situation. Therefore, I differ from a number of possible objections or points that may be made on section 2. I am the far end of the spectrum from those objections but I respect them and the entitlement to make them. The House should provide the full time and opportunity for the airing and clarifying of any sections or points that may be made on Committee Stage.
The first point I would like to put to the Minister is to what extent he is able to inform the House of the details of the analysis and survey carried out by the Department of Health into the overall picture in so far as it affects the prescription and the authorisation of medical and non-medical contraceptives, the extent to which contraceptives are available evenly across the country or unevenly. The Minister made clear on Second Reading that there were large regional sectors of the community where the provision of contraceptives was totally inadequate. I want to know whether section 2 of the Bill really addresses that problem and will help to ameliorate it because that is a real problem and I want it faced. I am sorry that we have to face it at 10 o'clock in the evening and perhaps until midnight and beyond. Let us face it as best we can and let us approach it under the constraints that have been forced upon us by some defensiveness that I do not subscribe to. Let us at least have as full information as possible in trying to assess the implications of the Bill.
The Minister.
I will give way to Senator Robb.
There are a few points I would like to make, and I will start by saying that I hope that the constructive way in which the debate took place for so long will be continued. I endorse the remarks made by Senator Robinson that this is a very important debate to those who are for the Bill and those who are against it. It touches some very sensitive areas and some very private areas of living and it inevitably touches some very raw, sensitive and tender nerves. Therefore, let us hope that, in the time available to us, in spite of the late hour and in spite of the fatigue, we will be able to continue in the way in which we have conducted the debate throughout most of the day.
I would like to ask how the health boards are constituted. Are they anything like the Northern health boards where one-third are nominated, one-third are representatives from institutions and one-third are indirectly representative of the people in that names are put forward for nomination by the local district councils and the Minister, very often from another country, decides who are acceptable and who are not? One of the ways in which our local council got over that was by putting forward only one name.
It strikes me that if this Bill becomes law it is only right that the people should have access to what is promised them. Already we have heard difficulties of conscience expressed, which we should all respect. There is no way in which a doctor, a chemist, a health board official or whatever should be obliged to do something individually which is against his conscience. Having said that, if this Bill becomes law we must also ensure that the maximum encouragement is given to pharmaceutical chemists, registered medical practitioners, the employees of health boards, to develop a proper, adequate and effective family planning service and also to whatever is meant by "an employee acting as such of a hospital providing maternity services or services for the treatment of sexually transmitted diseases."
It seems to me that that phrasing gives rise to a lot of very serious questions. What is meant by "an employee acting as such of a hospital providing maternity services?" Who is qualified to act in this respect? What is menat by "those employed in the treatment of sexually transmitted diseases?" Are we talking about medical people, nursing people, paramedicals or what?
Subsection (4) of section 2 mentions "an agent acting as such of a person making available a family planning service." Senator Ferris has already emphasised the very important need to define what is meant by "an agency providing a family planning service", the sort of training such people will have. Can the public be guaranteed that they will be people who are sensitive to the traditions of the country, to the family planning needs as defined in the Bill, in the areas of morality and deviance from morality, and sensitive in the whole area of sexually transmitted diseases? How well qualified will these people be? How will those family planning clinics be supervised? What is meant by "a servant or agent acting as such of a person making available a family planning service?"
If the health boards were set up, as I assume they must have been, by an Act of Parliament, and are subject to the Oireachtas, then if the Oireachtas passes a Bill it is absolutely essential that, in spite of respecting the conscience of those employed, there is every possibility of ensuring that the health boards can, in fact, create an outlet for the type of service which is envisaged. I would be very interested to hear what the Minister has to say about these matters.
Senator Burke rose.
Acting Chairman
Before Senator Burke speaks, I would like to explain to the Minister that I might not be as alert as I should be. I called the Minister unfortunately in error because Senator Robb indicated earlier that he wanted to contribute.
I have a point to make. During my contribution on Second Stage I asked the Minister what was the situation with regard to the present outlets in third level institutions and if they have been dispensing, heretofore, non-medical contraceptives, how now does the Minister propose to deal with those institutions?
I regret, like my colleagues, that it has been decided to put this Bill through the House needlessly.
That is not true.
Acting Chairman
It is only right that I should say at this stage that while I allowed Senator Robinson to debate that matter for some time I should now point out, although I do not mind a passing reference to it, that that aspect of the matter was debated, voted on and decided by the House. That should be accepted at this stage.
I certainly cannot be against the rules of the House in making that passing comment.
Acting Chairman
I have simply raised the matter to indicate that I feel——
On a point of order, I do not think that is a fair comment from the Chair. Senator Robinson and Senator Ferris continued a Second Stage debate. The Chair is now controlling the debate in relation to Senators from this side of the House. That is very unfair.
Acting Chairman
I do not feel that is a fair assumption of what I intend to do. I feel that I was probably incorrect in allowing Senator Robinson to continue that aspect of the discussion for so long. It is again only right that I should point out that that aspect of the position was discussed, and a decision made by the House on it. A passing reference can be in order but I do not know, if from any side of the House, we will achieve anything by redebating what has already been debated and decided upon.
Before Senator Fitzsimons continues, would the Chair clear one point with me because the Minister of State has me a little upset? Are we now taking all of section 2? Are we to make all our points to the Minister and then he will reply to every contribution or do we, as normally in this House, make a point and the Minister replies and then another point is made? Would the Chair clear that please?
Acting Chairman
I will clear it certainly in so far as I came into the Chair when the discussion on section 2 had already started. I assume that the discussion is and will be on similar lines to a discussion on Committee Stage of any Bill, I called the Minister in error. I want to clear this so that there will not be any feeling that I am not acting as fairly as I can. I called the Minister in error when Senator Robb had already offered. After Senator Robb, Senator Burke and Senator Bulbulia offered, Senator Fitzsimons offered and was on his feet; Senator O'Toole has got up on a point of order, and I am sure the Senator rose on a point of order.
I am still asking the Chair why are we not taking the sections of this Bill as we normally do with a question and answer with the Minister present? That is all I am asking.
Acting Chairman
As long as Senators are offering to raise a particular point on Committee Stage, I understand it is normal that Senators are accepted as they offer and when the time arrives when Senators are not offering I expect the Minister comes in. There is no restriction on Senators discussing a matter any number of times they wish. That is how I assume the debate will be conducted, as is usual.
The reason that I offered was that it seemed to me that it was not similar to the Committee Stage for other Bills and possibly that you were taking contributions from every Member in toto. I certainly have no objection if the Minister wants to reply to the points already raised. I can come in afterwards.
Acting Chairman
The Minister has informed me that he is willing to reply to the debate so far and we will have the Minister.
First of all, I would like to say that in my concluding remarks on Second Stage I made what I thought was a clear political charge collectively against a certain section of this House. I could have in actual fact, having sat here listening to this debate for quite a long time last week and continuously almost from 1.15 today, except for one very short break, referred to many of the things that were said and more particularly to one charge that was made against the Minister and his friend by a Member from the Opposition side of the House last week, but I did not even bother to refer to at all. I thought that the remarks I made were a total political charge. Do people take umbrage over these particular things? We hear them every day in politics. I do not see any difference between Seanad Éireann and many other places.
Senator Fallon referred to a number of things. Basically he is talking about the conscience clause which is in section 11 of the existing Act which was introduced by the Leader of his party in 1979. Senator Ferris asked if an application was made to the Minister to open a family planning clinic what were the criteria involved. I will just give the details, but I already referred to these in my Second Stage speech. First of all, the operation would want to be of a very high standard. Secondly, there would certainly need to be medical supervision of it. Then an application for a licence to import contraceptives must be made under section 5 of the family planning Act, 1979. First of all, you have the name and address of the applicant or, if the applicant is a company or other corporate body, the name of the secretary and address of the registered office. Secondly, if the applicant is a pharmaceutical chemist or a dispensing chemist and druggist he has to state his professional qualifications and addresses and at which address or addresses he has his shop; does the applicant require contraceptives for sale to persons specified in section 4 (1) (b) — that will be section 2 now of course—or solely for sale by him. If the applicant is not a pharmaceutical chemist or dispensing chemist and druggist he has to state (1) place of business, (2) his status in the company or corporation and (3) to whom it is proposed to sell contraceptives. That is specified in the Bill. That is basically what it is about. The Bill requires the highest standards possible in relation to an application that would come before the Minister in relation to setting up a family planning clinic.
It is under medical supervision?
It is under medical supervision. If at any stage the Minister sees fit to withdraw that licence because it is not coming within the ambit of the Bill he will certainly do that.
May I ask the name of that document that the Minister was reading from?
The Statutory Instruments, Health and Family Planning Regulations 1981. Senator Robinson talked about the inter-departmental review. It is an internal document. It is there for the information of the Minister. The Minister in his speech to this House quoted a certain number of things that were contained in that internal document. It is up to him to quote whatever he likes and to leave out, I presume, whatever he likes as well. From the information available within the Department licences were issued for the importation of approximately 100 million condoms.
It has gone up.
Permission was granted for the importation of these. From the information available, as a result of this review, it would appear that approximately 30 million of these were imported.
Senator Robb talked about how the health boards were constituted. First of all, there has to be a majority of elected representatives on a health board, representatives of county councils and local authorities of one description or another, paramedicals, doctors and so on.
Mention was also made of the conscience clause. The conscience clause exists in this Bill as it did in the previous Act. Nobody is under any obligation whatsoever to handle contraceptive devices of any description that they do not want to handle. The Senator also talked about who would be a competent person to decide? It would be up to the health board to question who would be a competent person to identify disease or who would be a competent person to sell or distribute contraceptives.
May I ask a question in relation to that? Senators have already pointed out that a health board may in conscience vote against carrying through effectively the enactment of what has been decided by the Oireachtas. I may have taken that up wrongly.
That is right.
If that is so, presumably the Government would ensure that, if the health board as a whole in conscience could not deliver the family planning service envisaged in this section, they would take other steps to ensure that an alternative means of providing similar outlets would be available. I could anticipate the conscience clause applying to all the members of a health board in which case the whole thing would be stymied from the start. Could the Minister reply to this?
To follow up on that I would make the point that already one health board which we all know about, the Midland Health Board, have held a meeting and made a decision not to implement the scheme. That being so, will the Minister say what role, if any, the Minister has in that situation?
I thank the Senator.
I am very concerned about this section. We all know that even under the 1979 Act quite a large number of pharmacists and doctors refused to dispense those items under any circumstances. When this Bill is law we recognise that contraceptives will be made available throughout the country. I would like to know what provisions the Government are making for areas where chemists or doctors refuse to make contraceptives available? If all citizens are to be treated equally, I would like to see the Government making some provision for areas like this. There have not been any consultations between the Government, the Minister and the pharmacists or, apparently, the health boards. There is no guarantee, even after this Bill is passed that contraceptives will be available in many parts of the country. For that reason it is important that the Minister and, indeed, the Government would tell us here tonight what they will do in such situations where a health board refuse to implement this Bill.
This is a very important issue. I would like to point out to the Minister that the conscience clause is something that is very open to possible abuse. I can sympathise with the idea of a conscience clause that applies to an individual who has a particularly strong feeling about it, although I feel the important conscience is the conscience of the user of family planning, not the conscience of the provider. I cannot understand why the conscience of the provider — for example, the chemist — is to be regarded as more important than the conscience of the people who actually want to use family planning within their marriage.
I am very worried about what are sometimes handed down as ethical rules in hospitals, imposed on doctors and nurses from above. That is what appears to be happening, according to Senator Fallon, in the Midland Health Board. The health board have great impertinence trying to bind the conscience of their entire force of employees not to implement a family planning service. That is a disgraceful attitude for a health board to take up, thereby denying the rights of all the people living in that health board area to make their own decisions.
I would deplore health boards behaving in this manner. I strongly suspect that when they do so they may very well be doing so for political rather than conscience reasons. It is very important that the Government ensure that conscience clauses are not abused so as to deny a service to people in various areas throughout the country who need it. After all, the Minister brought the Bill before the House in the first place because the consciences of various chemists and doctors have denied this service in many areas throughout the country where it is needed. Are we to allow this kind of conscience clause to carry over into a kind of collective conscience where there is a gang-up of people in a health board, or indeed in the management of a hospital? I conceive of the possibility of allowing an individual hospital employee or health board employee who feels extremely strongly about the matter not to deal in that area and perhaps move him or her sideways into another job.
But I fear there may be an effort in hospitals and in health boards to exercise a kind of collective conscientious clamp down. If there is such an effort the Government must be prepared to take some action to deal with such a situation and to ensure that conscience clauses are only operated regarding individual consciences and not in this way.
The section we are discussing deals with access. Points of access are very clearly made in this section of the Bill. It would be a very strange backwater indeed — perhaps we have those kind of backwoods areas—where there would not be a chemist, doctor, or health board who would not go in or there would not be a maternity hospital. I am determined to be optimistic about this Bill. I hope that all the negative forces do not combine in one area to deny people what is their constitutional right —access to family planning.
I would prefer to see family planning advice and service given to an individual by the family doctor who knows the patient in a holistic sense and would treat the patient in a family and personal context. I accept that where such is not available the next step is the family planning clinic or a pharmacy. Funding, as we are all aware, is in short supply in the health services. I would like to know if this is to be extended through the health services and, if clinics are going to be set up, will extra funding be made available to do so under the terms of this Bill? All the health boards are in very short supply of cash. I would hate to see that being used as an excuse for failing to provide a service under this Bill. I would like assurances of that nature from the Minister when he replies to this section of the Bill.
I would like to know if training programmes will be made available to people, because the method of family planning which is decided upon by a couple should be decided upon after advice and consultations? Those who are in the business of giving non-medical contraceptives should be equipped with a degree of information. The Minister has dealt with the criteria for family planning clinics adequately in his reply. I take it that we are dealing with the age section when we have completed this access part of the Bill. I will withhold my comments on that for the moment.
On the question of extra funding being made available I would like a reply on that. The setting up of an establishment and, indeed, active encouragement of training programmes for medical and paramedical employees is an important aspect. In the Second Stage speech I made I asked about removing the relevant section of the Censorship of Publications Act which makes it illegal to advertise sexually transmitted disease clinics. Since one of the outlets for non-medical contraceptives is to be these clinics and since these people in particular should have made available to them non-medical contraceptives, I feel it is important that they should know where to go and I would like assurances that that relevant section of the Censorship of Publications Act would be repealed in order to allow meaningful information to be given to the public about where to go for treatment of sexually transmitted diseases.
In my Second Stage speech I put a lot of emphasis on the cost of implementing this legislation. I should have liked the Minister to tell us where he is going to get the money for this Bill when you see all the other cuts right across the board. In section 2 of this Bill we use the words "control of sales" of contraceptives. I wonder will this be possible. The Minister did state in his address to this House before we commenced Second Stage that his senior officials would monitor the sale of contraceptives. Like my colleague Senator Robb, I spoke about four times in my Second Stage speech of the worry I have regarding the role of the doctor. Maybe I am wrong; maybe the doctor is not gone out of the scheme altogether. This comes under section 2. I get the impression from listening to what doctors said and listening to Senator Robb that we may not have any control of the younger people. Again, I emphasise the younger people, because we know that young people are going to get contraceptives; perhaps they have contraceptives and will continue to use them.
Would the Minister give me some guarantee that the doctor will still have a role in the supervision of the sale of contraceptives? Senator Bulbulia has just spoken about the role of the doctor. I still feel that the doctor has a role to play when everybody else seems to be saying that it has gone out of the doctor's surgery. All the emphasis in the Second Stage speeches was on the waste of time in doctors writing prescriptions. Again, I am asking for control, and suggesting that there should be still a role for the doctor in regard to young people using contraceptives. It was not that I did not think the family doctor, the hospitals and the health boards would not do their duty properly in providing outlets under this new Bill. I did not mean that, if that was the way it sounded. Some Senator said you would imagine by the way some Fianna Fáil Senators were talking that there was going to be a flood of contraceptives for everybody to use and that they were going to be sold everywhere. I think it was Senator Michael D. Higgins who said it.
Widespread distribution.
If they are to be as freely available as that, I did not mean in my contribution that the chemists, doctors and the health boards would abuse their new role. Senator Fallon and other Senators have mentioned the health boards. Indeed, we all have very intimate knowledge of how health boards work. I certainly would be concerned about the role I see the clinic in Ennis playing in this matter. I have been quite broadminded. Some people thought I would have made a different speech completely here on Second Stage. I absolutely recognise and accept the concept of using contraceptives. I understand and recognise the difficulties but I still see great problems with health boards and the cost. There is a whole new concept here. Are we talking about health boards or the clinic in Brendan Street in Ennis now selling contraceptives to 18-year-olds? Perhaps some Senator directly serving on a health board will tell me if it is usual to have money transactions by a health board? Is it new?
Other people are talking about health board personnel with conscience problems. I am not going to go into that part of it but I certainly see problems for some health board employees trying to control the sale or distribution of contraceptives out of the health board units that I am very familiar with. I accept that the Government have won. "Victory" was a term not used by all Government speakers. I must agree with Senator Robinson that it is unfair to us to be taking the Second Stage of a very important Bill in this way. We cannot come back next week and change the decisions that will now go through and become law. While we are talking about control, I am also worried about costs. Under the Bill, it is clear that young people are going to get contraceptives. As a mother I will say that I do not think that any of us want youngsters of 12 years of age getting contraceptives. It may be that it is fashionable to do so, but I do not think that those of us who are fathers and mothers want this. I have not seen here or in the other House a figure for the cost of implementing this legislation. That is a factor that must worry all of us who have now accepted that this Bill will become law. Or, is it just going to be put aside again after upsetting everybody?
Senators made very sincere contributions. I had no problem in coming here and speaking on this Bill. For the benefit of anybody who did not hear me, I spoke on Thursday, 28 February. I still have the worry that the Bill will not be implemented properly, first, in regard to control and secondly, in regard to cost. I hope when the Minister is replying he will forget about all the hassle we had earlier this evening and that he will respond to the points I have now made.
I do not consider that I had any hassle with the Senator at all. I would like to be allowed to make a few points. I intended to reply to Senator Burke who spoke about contraceptives being made available at third level education institutions. Basically, this is illegal at the moment.
Senator Hussey spoke about outlets and the difficulty in obtaining contraceptives in many places. We do not anticipate any great difficulty. If, as a result of this legislation, there is a certain amount of difficulty it will be up to the Minister to review it.
Senator McGuinness spoke about the conscience clause which I have already referred to and there is no point in repeating what I said.
I put a specific question, is it possible for a health board to operate a collective conscience and forbid its employees to provide the service?
It is up to any individual within the health board. I presume that if all members of the health board decided that they would come within the conscience clause, it would fall flat.
I had offered to speak specifically on this point as a member of a health board. The Bill before us——
Acting Chairman
Could the Senator allow the Minister to conclude on the point he was making?
The health board are under an obligation to provide the service under the family planning Bill. There is an anomaly there. We do not anticipate any difficulty in getting people to operate it. Senator Fallon also raised the point in relation to the health boards, because they are under an obligation to provide a family planning service under the previous Act. The 1979 Act states:
"family planning service" means a service for the provision of information, instruction, advice or consultation in relation to any one or more of the following:
(a) family planning.
(b) contraception.
(c) contraceptives.
This basically answers the question.
Senator Bulbulia talked about extra funding. We do not anticipate that any extra funding will be needed.
Acting Chairman
I feel that we can come back to the point. There are at least two Senators offering to speak on this point.
Specifically on the health board aspect of it, I would hope before the Minister would conclude that he would listen to all the contributions.
Acting Chairman
There will be an opportunity to come back on it.
Senator Bulbulia made the point that we should provide extra funding. We do not intend to provide such as there are enough outlets there already. We see no problem in that direction and we do not intend to amend the publication referred to.
Senator Honan referred to winners and losers. There is no such thing as far as this Bill is concerned. The Senator may be inclined to think that her side have lost this issue but this is legislation for all of the people.
I did not make that point at all.
The Senator talked about winners and losers and I have just made that point to reply to her. She also indicated that young people may have access to contraceptives. It is up to the people who are selling contraceptives to ensure that only those entitled to them can get them. It is their responsibility if they sell contraceptives to people under 18 years of age.
The Minister said the opposite. The Minister for Health said it was the responsibility of the purchaser, that he would be the only person committing the offence if he is under 18 years of age.
It is the responsibility of the person who is selling the contraceptives and not the responsibility of the purchaser and so I am informed reliably. Indeed, the fines as proposed in the 1979 Act are still there. It is envisaged that they should be rigorously applied to all people who break the law in this connection.
Acting Chairman
Senator Robinson has been indicating for a long time that she wants to come in and on the specific point of the health boards I think Senators Loughrey, M. Higgins and Robb are, at least, offering to come in.
I am not narrowing specifically on health boards. My query relates to health boards among other matters. I want to pursue the issue of the information available to this House. In response to the question I raised in my contribution on Second Stage and which the Minister of State has now replied to on the review of the operation of the family planning legislation, that is the Health (Family Planning) Act 1979, the Minister of State has said that this is an internal document and that it is for the information of the Minister. I would like to ask on what basis was that decision arrived at because we have to come to a legislative decision on a change in the law and on what are the proper outlets and extension of the existing legislation? How are we to come to a properly informed decision, on the role of the health boards, on the needs of ordinary people for access, particularly women of child-bearing age, mainly married women? I am not scrupulous on that: I am anxious that they have access to full information and supportive help. I would agree with Senator Bulbulia; I would have a personal preference that help would be in the privacy of their relationship with their GP. That is the best concept. I would like to know to what extent that is operating in Ireland. I would have personal views and I would have some personal knowledge.
I do not have a comprehensive picture and the Minister does. Why do we not have that comprehensive picture? Why do we have bits of it said to us in a sort of piecemeal way in his opening speech?
I have already complimented the Minister on a lot of the things he said in his opening speech but basically, we do not have acccess to the information which we need. Why are we speculating about something that is known? This information is in the hands of the Minister and why is it not in our hands? I say that as somebody who is very committed to furthering access to information on, knowledge of and access to family planning. I have been since the start of my career in public life committed to that. Why, now, when the Minister has access to a full review of the existing position are we having, late at night regrettably, this piecemeal and rather uninformed debate? I do not have access to the information which the Minister has and that is my general point.
If I could come to the specific of the issue which has been raised, a very important issue, the role of health boards. I find it very difficult to reconcile any decision of the health boards with the terms of the Act under which I assume they felt they were making that decision, namely, the Health (Family Planning) Act, 1979. In so far as there is a conscience clause in that Act, it is purely related to individual decisions by individual persons. Section 11 of the Health (Family Planning) Act, 1979 provides:
Nothing in this Act shall be construed as obliging any person to take part in the provision of a family planning service, the giving of prescriptions or authorisations for the purpose of this Act, or the sale, importation into the State, manufacture, advertising or display of contraceptives.
That relates to an individual as an individual, a person taking a decision. It is a conscience clause to allow that person to avoid being personally involved in prescribing or authorising the prescription of, or supplying contraceptives. I do not have any particular argument with it provided it is seen as an individual conscience clause. Apart from that, there is the structure of the family planning Act itself and the role of the Minister and the role of the health boards. In section 2 of the Act the role of the Minister is to secure the orderly organisation of family planning services. A large part of how he does that is through the activities of health boards in health board areas. In section 2(b) it says:
provide a comprehensive natural family planning service, that is to say, a comprehensive service for the provision of information, instruction, advice and consultation in relation to methods of family planning that do not involve the use of contraceptives.
When I was making my Second Stage contribution I made it clear I would welcome an amendment of section 2. I would welcome a change in it that provided an across-the-board obligation on health boards to provide a comprehensive family planning service. At the moment there is an obligation on the Minister to secure an orderly provision, and an orderly provision means access. It means that there must be access in each area to a choice of methods of contraception and methods of family planning. That orderly access can only be achieved through the operation of health boards if there is a problem in relation to individual GPs and chemists in the area. GPs and chemists can individually invoke the conscience clause. If you want an orderly provision of access then it must come through the health boards. Therefore, there is a most important issue which the Minister of State must assist the House by clarifying. I ask him to reconsider the position on that review. Has he actively confirmed from the Minister that that review is positively not available to this House? That is a matter I specifically raised at Second Stage. If it is positively not available, why is it not available?
Before the Minister replies I want to give the reasons why I am worried about this—Senator Loughrey is also a member of a health board. I say this as a lay person in relation to drafting of legislation. I was watching a programme recently on the conditions in mental hospitals. Relatives of patients and individual patients were being interviewed. At the end of the day we heard a patient explanation of the reforms that had been built into the Mental Health Act, 1981. Afterwards, a whole host of people raised the question with me about the difference between rights existing in a statute and their actual delivery to people in hospital. I began to wonder what mechanism existed in that Act at that time to make sure that the protections which were spoken about would actually be delivered into the experience of the people in the hospital. I could see that in that kind of failure you could frustrate the spirit of the legislation. I believe a statement has been made to the House that a health board has decided, or may decide, that it would not, on grounds of conscience, implement the Bill that is now likely to be an Act of the Houses of the Oireachtas.
Going back to my Second Stage speech, I said that one of the reasons — not the primary one — why I was in favour of the passing of this law was to bring the law closer to actual practice, so that we would not be seen to be blatantly breaking the law and encouraging the breaking of the law. If we are going to have a list of representatives and some professional people on health boards deciding that they are above and beyond the Houses of the Oireachtas and that they will decide that they have such a thing as a collective conscience that can be consulted by a majority vote, what is the point of this legislation? I am a member of a health board that discussed this matter and decided on a negative attitude at one stage, not by a general vote or a consensus, but by a crude majority vote. What is the point of legislation —the Minister must answer this — if you are going to allow that kind of nonsense to prevail? The Minister and I share the same constituency. I am interested in the facts that have been made available about Connacht, that there are areas in Connacht where the longest distance has to be travelled to find places where forms of contraception will be available. Are we to have the absurd position where somebody can stand up at a health board meeting and say "We are not going to implement this for this reason or that reason"?
On this matter, there is need for ministerial clarification. Indeed it would be better if this matter were made explicit in the Bill before us — the word "rights" has been used a great deal during the debate — so that the rights of those who, after a very long struggle in relation to access to contraception, have succeeded in establishing access, would be protected from this kind of cowboy activity. That is just what it is. I want to be explicit on that.
Section 11 of the 1979 Act which has been quoted by the previous speaker says:
Nothing in this Act shall be construed as obliging any person to take part in the provision of a family planning service, the giving of prescriptions or authorisations for the purposes of this Act, or the sale, importation into the State, manufacture, advertising or display of contraceptives.
It is necessary for us to be very clear this evening as to what action will be taken to make sure that that clause will not be abused so as to frustrate either the 1979 Act or this amending legislation of 1985. There is no room for ambiguity in relation to those people who need this service. Are we going to say: "We will leave it ambiguous and then we can go on to let the poor unfortunate people involved establish their rights through the courts"? This is the kind of crazy situation that could be created.
I have sympathy for Senator Honan's point of establishing exactly what is meant by "control" in the section but I am sure even Senator Honan, because she is a fair person, will agree that one would like to see the spirit of legislation being implemented first, before it would be abused by over-supply. The question that is being asked of the Minister is how will he ensure that there will be no activity of this kind. It is not an abstract question. It is one we know of. We have heard of a health board that is moving in this direction. I have referred to one that has tendencies in this direction. What specific measures are we going to take to ensure that this does not happen? There is no point in saying that this will not arise. It will arise. It has arisen. What is going to happen about it?
I have read section 11 of the Health (Family Planning) Act, 1979, on the conscience clause. I have discussed this with people who work in hospitals and gynaecology departments and obstetric departments, people involved every day in taking problematic decisions. Does this mean that a person can develop an attack of conscience more or less without notice? How would one operate the delivery of health services in that regard? As I understood it a conscientious objector was somebody who was abstracting himself from what was accepted as the law, the given situation and he would put himself in advance, into some formal roster or make some formal statement so that he would not be put into situations where his services would be required. That could frustrate the delivery of health services or the delivery of any new facilities. Otherwise, it is totally meaningless. They could say that it is the law now but if we form a conscientious group we will be able to frustrate the delivery of the service, or we will all get together in the health board and form another group to frustrate the implementation of the law. That is making a mockery of the law. What is needed is a statement from the Department of Health and the Minister for Health that this will not be tolerated. He needs to do that in the interest of women's health and anyone's health who is affected by what we have been discussing for the past couple of weeks.
I, too, am a member of a health board but I share with other Members a responsibility with regard to the passing or rejecting of this Bill. We have a specific duty to perform here tonight. In fairness to the House, the Minister of State has a specific duty to perform. I contend that the Members of this House should be fully informed with regard to the obligation on the health boards to implement this legislation. The obligation is on the health boards. The decision of a health board rests on the shoulders of the members of that health board. If the staff of that health board make a conscientious decision not to perform or carry out specific jobs in relation to the sale or distribution of contraceptives they, in conscience, can abstain from working in that area. As was pointed out, if the health board as a body decide not to conform with the Bill, what happens then? We have been getting vague and negative responses from the Minister. Unless we get a positive response from him I propose the adjournment of the House until such time as the House can be fully informed of the position with clarity.
It surprises me, at this stage of the debate, to see the concern by two Senators on the other side of the House, Senator Hussey being one, about the availability of contraceptives. That party have opposed the availability of contraceptives all along. We hear the term "conscience clause" and we now have a new one, "the collective conscience clause". I can think of nothing less conscientious than the collective conscience of Fianna Fáil acting as a group.
No politics at this hour of the night.
There are no politics. It has become very clear to me, and the Minister must clarify this, that if the Fianna Fáil Party as a group are going to try to frustrate the laws passed by the Oireachtas by directing or requesting members of the health boards specifically to frustrate the implementation of this law then my second speech should become a more real——
On a point of order, Senator Loughrey should withdraw that statement. At no time did any Member of this House say that we would ask our members on the health boards to frustrate the legislation passed by this House.
It is a political charge and the Senator had better withdraw it.
If it needs to be withdrawn I will withdraw it but I would like somebody, on behalf of the Opposition, to give an assurance that they will not direct their members on health boards to frustrate this law and that they will not act as a group. In spite of what Senator Higgins said, I am not a member of a health board but I am very concerned, from the contributions I have heard, that they may act as a group.
That is a completely political charge and there is no obligation——
He has been at it since early today.
There is no obligation on anybody on the opposite benches to reply to it. There is no point in following that line.
You mean we will not draw any inference?
Where will it get us?
I respect the Chair and I always will, but I respect this House and I respect the other House. I respect the three elements of the Oireachtas. When laws are passed I would expect all our citizens, including the active members of Fianna Fáil on health boards, to respect those laws and I hope that they will. But lest they or any other group might not, I ask the Minister to be specific and state that the conscience clause will not be invoked by groups and that if it is to be invoked at all, it will be by an individual member — a doctor, a chemist or a member of the health board. I respect the right of an individual to invoke that clause but I would not respect the invocation of the conscience clause collectively, particularly by the Opposition. If this happened it would mean that this debate would be totally futile.
One gets the impression from section 2 that we are talking about an infectious disease rather than about something which whatever about the moral teachings of my Church, has been regarded by the vast majority of women in society where these facilities are available as probably one of the greatest boons that has ever been developed by science or technology. It reminds me of the reaction of people to the prevalance of AIDS. They want to be safely protected from it behind a cordon of legislation.
I want to add my voice to the voices of a number of people who have pursued the question of health boards and their willingness or otherwise to implement this and the interesting concept of the collective conscience of a group of people, who happen to be statutorily drawn together as a health board, and their capacity to extend their consciences particularly into the bedrooms of other people. My choice of phrase may not be the best.
In subsection (1) pharmaceutical chemists who are limited companies are still excluded. This has resulted in large numbers of pharmaceutical chemists being excluded from the legal right to sell contraceptives because they are not individual pharmaceutists but limited companies. They are not covered by the provisions of the Principal Act and there is no reference to an amendment to this in the Bill. Is it an omission or is it deliberate policy? If it is deliberate policy, why is it? It means that many of the larger pharmaceutists in many of our larger urban areas are excluded from the provisions of this Bill. It has been drawn to my attention, on many occasions, that limited companies functioning as pharmaceutists are not clear on whether they are covered by this legislation.
I support what Senator Ryan said about limited companies. It should be made clear that pharmacies that are limited companies should be able to provide contraceptives under the legislation. As regards the health boards, for the assistance of the Minister I should say that lest the word "person" in section 11 of the Principal Act be interpreted as including a corporate person such as a health board, I have put down an amendment for Report Stage which I hope will make it clear that the conscience clause will not enable health boards to refuse to provide a comprehensive family planning service. I hope the Minister will be able to deal with my amendment on Report Stage and that Senators on all sides of the House who have expressed worries about this will support it.
We are probably speaking about two different functions. We all agree, and it has been confirmed by the Minister, that there should be a clause included in the Bill to cover those who are conscientious objectors to the sale of contraceptives be they doctors, chemists, health board officials, or persons working in a hospital or in a family planning service, although that is the least likely place to find a conscientious objector.
It is important to differentiate between the two conscientious objectors. It is accepted that people selling contraceptives should have the right to have a conscientious objection. We are not in a tyrannical State and would not want to insist on people doing something that they had moral objections to doing.
On a point of order, section 11 of the original Act states:
"Nothing in this Act shall be construed as obliging any person to take part in the provision of a family planning service,"
That is much wider than the selling of contraceptives.
Section 2 of the same Act states that the Minister shall secure the orderly organisation of family planning services. There is an obligation on the Minister to do that. I am a member of a health board but we have not made a decision such as that which was reached in other areas. If a board decides to direct their chief executive officer not to provide this service, the Minister may have to ensure that section 2 of the Act comes into play to make sure there is an orderly organisation of family planning services. I am open to correction but I take it that where the board may not want to provide the service, if people within the board want to provide it then they would be perfectly entitled to do so under law because it will now be legal to sell contraceptives at health board clinics.
In the process of discussion, we can overcome any problems that might arise. It would be anomalous if we passed the legislation and suddenly everybody decided they had a conscientious objection. An individual may have a conscientious objection. The health boards have a responsibility to provide such services under the Act and the Minister has an obligation to secure the orderly organisation of family planning services. That is how I interpret it.
The problem seems to be with the conscience clause. Should the health board and all the employees of a health board decide to invoke the conscience clause and not to provide a family planning service then it will be up to the Minister to take the necessary appropriate action.
Has he authority to do it?
The Minister will review the situation in the light of the circumstances prevailing at the time. We are fully convinced that the situation will not arise. If there are a lot of conscientious objectors, which is unlikely to happen, it is up to the Minister to look at the situation and make the necessary orders.
Has he the power to direct the board?
The health board as a body makes the decisions. It is up to the chief executive officer to advise staff and tell them how to implement the decisions of the board. The CEO is responsible to the board. If the board makes a conscientious decision collectively, the Minister of State said it was up to the Minister for Health to take appropriate action. What is this appropriate action?
The appropriate action that the Minister has in mind is to direct the health board to provide the services.
I want to make as much progress as I can on this. I assure the Minister of State that I appreciate his response in trying to relieve whatever confusion has surfaced. Section 11 of the 1979 Act states:
Nothing in this Act shall be construed as obliging any person to take part in the provision of a family planning service, the giving of prescriptions or authorisations for the purposes of this Act, or the sale, importation into the State, manufacture, advertising or display of contraceptives.
Senator Ferris suggested that in the unlikely circumstances of members of a board deciding that there should be such a concept as a conscience that they would all exercise collectively—which I absolutely reject as being against the spirit of section 11 of the 1979 Act — we would then have individuals and groups privately, without breaking the law, doing what the health board had decided by a majority not to do. We would then be in the crazy situation of having, after all these years spent discussing the availability of contraception, to look at some private provision where the people responsible for the health of a whole region were deciding to frustrate the implementation of the legislation. That would be absolutely monstrous. My sympathies are entirely with the kind of thinking that Senator McGuinness has suggested.
The Minister of State has not clarified the interpretation of that section. I am not satisfied. I contributed nearly 12 years ago on family planning legislation in this House. After all this time, I would not accept it as satisfactory if somebody in Galway city, where I live, who wanted contraceptives had to wait for this legislative struggle for a decade and a half to get through the Oireachtas and past the whim of a health board. It is such a monstrous suggestion as to require amendment of the Bill, if necessary. I will support an amendment to stop that kind of activity which is absolute subversion of the spirit of both of these Houses. Let us accept the conscience clause, but we need clarification on the point. It is just simply not good enough to say that if this situation arises the Minister will then review the matter. We are entitled to anticipate the action of the Minister. We are entitled to know the powers of the Minister. The people will have to realise that the two Houses of Parliament, having decided this matter, must now watch on as the health boards go through the motion of deciding by a majority vote whether they will supply the services. It is making a mockery of democracy.
I have no responsibility for the conscience of anyone. Senator Higgins made the point clearly. If this clause was used collectively then the spirit of this legislation would be broken. I presume that will not happen. The Minister has power to direct the health boards to provide family planning services. As a result if the health boards do not provide family planning services then the Minister will direct them to do so.
Does that satisfy Senator Higgins? It will be blurred.
I give way to Senator Robinson because I need to think about this. I agree that the confusion which could arise, in relation to public comment on this, could have a mitigating effect on the passage of the Bill.
I want to come in on the same point. I am not sure we are getting clarity at this hour of the night. A number of important issues arise. Section 11 of the 1979 Act is couched in terms of individual conscience.
Hear, hear.
Nothing can be more individual to a person than his conscience. It is inately related to the person. The exercise of it is also very precisely defined in section 11. It states:
Nothing in this Act shall be construed as obliging any person to take part in...
That does not let someone make a decision to pre-empt a situation. It is merely invoking, as a shield, their conscience from being obliged to do something. It is very limited.
Nothing in this Act shall be construed as obliging any person to take part in the provision of a family planning service, the giving of prescriptions or authorisations for the purposes of this Act, or the sale, importation into the State, manufacture, advertising or display of contraceptives.
As I understand it, that could be invoked by a person in a self-employed capacity saying: "I do not have to do this; I am not going to do it". It can be invoked by an employee saying to an employer: "I do not want to do this and you cannot oblige me to do it." I agree with Senator Higgins that it should be done in the context of "I know this is the law, I know this is legal, I know it is the purpose expressly wished by the legislation. I will not do it but I certainly will not impede it in any way." That is why I posed the question earlier which the Minister did not answer. It is ultra vires any health board to take a collective, positive, pre-emptive decision on this. I would like clarification on that. Has the Minister sought the advice of the Attorney General on this? Is there a position taken by the Department on this because it is a very important point? It is obvious that a health board has attempted to act in a manner which appears to be ultra vires.
We have to accept the Senator's clarification on that. We do not anticipate that the situation would arise. If it did arise——
It has arisen.
There are many people with consciences but the Minister has the power to direct the health boards to provide family planning services as it stated in this Bill.
I am informed by Members of this House that it has arisen and that a health board has taken this position. If so, then that health board has acted ultra vires. It had not the power to do what it purported to do. What will the Minister do about that? If the Minister is relying on operating under section 2 of the 1979 Act, the difficulty is that section 2 does not authorise the Minister to direct a health board to provide comprehensive family planning. I wish it did. It obliges the Minister to secure the orderly organising of a family planning service, which is slightly less straightforward, and then to provide a comprehensive natural family planning service. I wish it authorised the Minister to do what the Minister of State seems to think the Minister can direct a health board to do which is to provide a comprehensive family planning service. That is not what section 2 of the Act states. It would be better to rely on the fact that any purported attempt by a health board to invoke section 11 collectively in a pre-emptive way is ultra vires the health board. It is not what section 11 was intended to cover and it cannot be invoked in that way.
One of the most important points made today was that made by Senator Lynch. Unless we get a clear and unequivocal response to this important question we would be far better adjourning until such time as we get it. A few important principles have arisen as a result of this discussion. First of all, the one about majoritarianism which Senator Higgins mentioned. It is outrageous in a democratic State in the latter part of the twentieth century to see legislation thwarted by the idea that a majority vote equals democracy. Unless you are prepared to look at what the minority have to say you have not gathered the central core of the democratic spirit. Even if the worst came to the worst and there was one member of a health board who was prepared to go through with the legislation, as a minority on that health board he should be empowered to go through with it.
Many people talk about unanimity. There has been a lot of criticism of the Catholic Church but let me now turn the light on my own. I can remember in the election we have for our clergy, which is meant to be democratic, how the two-thirds majority was eventually achieved to elect an unfortunate Minister. He had to come along and give sermons on countless Sundays to go through this dreadful election procedure. It was then stated by a senior member of the Church: "now let us make the decision unanimous" in spite of the fact that there had been people in that room who had not voted for the result, who were prepared to accept the person but who had not made a positive affirmation that it could in any way become a unanimous vote. It could not be unanimous unless everybody had voted for it.
Regarding the conscience clause in a collective sense, unanimity, in conscience, demands the one thing that we seem to get away from in this debate, the right and the promotion of dissent. There must be the right and freedom to dissent in order to ensure that there has been unanimity in conscience. In Ireland, North and South, because of the imperial conditioning and colonialism that we have inherited, our attitudes, our constraints and all the forces that are locally used, very often on an important issue like this, the majority in a local community say they will not have it. It becomes almost an act of Herculean moral courage for the remainder to say they will not go along with them. I cannot believe that in the health boards, as constituted, everyone will agree, in conscience, that a law passed in the Oireachtas will not have their assent and they will not work it.
The Minister has a grave responsibility here. I will look very seriously for a good reason why I will not support the amendment Senator McGuinness proposes to make. The Minister does not anticipate any opposition to this. I remember one of the first Bills passed in the Seanad. It was the Litter Bill. Look at Ireland today and ask how much cleaner is it now than it was since the day the Litter Bill was passed through this House. Unless the Minister takes very seriously the reservations being made here, all the trouble we have had to get to this point in this debate will be as much a nonsense as the situation we find with regard to family planning.
I am not satisfied with the answer the Minister has given with regard to the appropriate action the Minister would, could or might have to take. He has replied to the question but he has not said how the problem can be solved. The Minister stated that he could direct the health board, but the health board in conscience did not comply with that directive or did not wish to comply with that directive. There is no three-way Whip on a health board as there has been on this Bill. Will health boards then be disbanded by the Minister? That can happen.
A Chathaoirligh, you asked me a question I am very rarely asked, and that is if I am happy with that reply. I thank you for the consideration in that and I can answer your question now. My own happiness is lessening in the two instruments that have been suggested. One was Senator McGuinness's point that in relation to section 11 of the 1979 Act we would clearly establish that it could not be construed in any way as applying to, let us say, more than the individual we have been discussing, groups of individuals collectively and so on. I listened then to Senator Robinson who on hearing that the Midland Health Board, for example, had taken their decision asked if the Minister would declare that they are now acting ultra vires and indicate what action he proposes to take against them and any such health boards. I think it is in the public interest-and I give the Minister of State adequate time to think about such advice as is necessary — that the Minister declare any such activity or any such interpretation of the Act to frustrate the basic spirit of orderly organisation of family planning services and so forth to be ultra vires. That would be enormously helpful and is demanded by the situation in view of the debate that we have had at this stage. The kind of person who needs an answer to that is the individual who might have anticipated using these services. What is that person to do?
The Midland Health Board have taken a decision on something that was proposed but is not law yet. I cannot understand a health board taking a decision on something they do not know the full contents of. If the health board take a decision on this because of its content, then under section 6 of the 1970 Health Act which is linked with this the Minister has the power to direct the health board to provide the facilities as outlined in the legislation.
Will the Minister of State, on advice from the Department, state now that any health board acting in this way will be construed as acting ultra vires and that he will immediately make an order so that the basic legislation will not be frustrated? Yes or no?
Yes.
I thank the Minister of State.
The Minister when he justified his attitude when replying on Second Stage made some general remarks and I want to make it clear that any time I referred to or addressed the Minister or the Minister of State I did so with respect.
I accept that.
I was not satisfied with some aspects of the reply. Since I came into the House it has been the practice that the Minister in replying to Second Stage would answer questions and refer to points brought up in the debate. The Minister this evening departed from that practice. On Second Stage I referred to the Minister's speech where he said that the availability on a legal basis of contraceptives in Northern Ireland did not result in the dramatic decline of moral standards. He stated then, ironically, that the abortion rate is now somewhat higher here in the Republic than in the North. It is very difficult to measure moral standards, but I stated on Second Stage that with regard to illegitimate births, venereal diseases, sexually transmitted diseases and legally induced abortions, the rates in the North were higher in all cases than in the Republic. I challenged the Minister to produce figures which would justify the statement that he made.
Senator Robinson also referred to this aspect of my contribution and stated that I did not give sources. Under those circumstances I think it only proper for the full consideration of this Bill that I would give these figures and the sources. I will be very brief in doing so. I want to refer to live births by legitimacy status and percentage illegitimate from 1949 to 1982. I will eliminate the numbers and just refer to the percentage. In 1949 in the Republic 3.1 per cent, in the North of Ireland 3.7 per cent; in 1950 in the Republic 2.5 per cent and in the North 3.4 per cent; in 1951 in the Republic 2.5 per cent and in the North 3.1 per cent; in 1952 in the Republic 2.5 per cent and in the North 3.3 per cent; in 1953 in the Republic 2.1 per cent and in the North 2.8 per cent; in 1954 in the Republic 2.1 per cent and in the North 2.9 per cent; in 1955 in the Republic 2 per cent and in the North 2.4 per cent; in 1956 in the Republic 1.9 per cent and in the North 2.7 per cent; in 1957 in the Republic 1.7 per cent and in the North 2.4 per cent; in 1958 in the Republic 1.6 per cent and in the North 2.3 per cent.
I do not want to interrupt but I thought we were dealing with section 2. Perhaps the documentation we are referring to now might be relevant on Report Stage to the Bill as a whole, but I do not know if it has any relevance to section 2.
I understand the Senator to be arguing against accepting section 2. To me he is in order.
I accept your ruling.
I will be referring with a purpose to some of the statistics later on. In 1959 in the Republic it was 1.6 per cent and in the North——
The one thing you do not do is make a Second Stage speech. You do not go over all the ground. You remain within section 2.
I understand, and I am doing that.
You are doing that at the moment.
In 1959 in the Republic it was 1.6 per cent and in the North 2.4 per cent; in 1960 in the Republic 1.6 per cent and in the North 2.5 per cent; 1961 Republic 1.6 per cent, Northern Ireland 2.5 per cent; 1962 Republic 1.8 per cent, Northern Ireland 2.4 per cent; 1963 Republic 1.8 per cent, Northern Ireland 2.6 per cent; 1964 Republic 2 per cent, Northern Ireland 3 per cent; 1965 Republic 2.2 per cent, Northern Ireland figures not available; 1966 Republic 2.3 per cent, Northern Ireland 3.1 per cent; 1967 Republic 2.5 per cent, Northern Ireland 3.6 per cent; 1968 Republic 2.5 per cent, Northern Ireland 3.8 per cent; 1969 Republic 2.6 per cent, Northern Ireland 3.7 per cent; 1970 Republic 2.6 per cent, Northern Ireland 3.8 per cent; 1971 Republic 2.7 per cent, Northern Ireland 3.8 per cent; 1972 Republic 2.9 per cent, Northern Ireland 4.2 per cent; 1973 Republic 3.1 per cent, Northern Ireland 4.1 per cent; 1974 Republic 3.3 per cent, Northern Ireland 4.8 per cent; 1975 Republic 3.7 per cent, Northern Ireland 5.1 per cent; 1976 Republic 3.8 per cent, Northern Ireland 5 per cent; 1977 Republic 4.2 per cent, Northern Ireland 5.4 per cent; 1978 Republic 4.3 per cent, Northern Ireland 5.8 per cent; 1979 Republic 4.6 per cent, Northern Ireland figures not available; 1980 Republic 5 per cent, Northern Ireland figures not available; 1981 Republic 5.4 per cent, Northern Ireland figures not available; 1982 Republic 6.1 per cent, Northern Ireland 7.8 per cent; 1983 Republic not available, Northern Ireland 8.7 per cent. Those figures have been obtained from the UN Demographic Yearbooks 1959-65 and the Eurostat Demographic Statistics 1984 and there is no controversy about them. A shorter list of legally induced abortions for Northern Ireland and the Republic 1974-82 and ratio of abortions to total number of births in the Republic and Northern Ireland——
It is like the sorrowful mysteries.
——indicates that in the Republic of Ireland——
Has the Senator no more recent figures?
From 1974 to 1982 is my latest figure.
Has he no more recent figures?
No.
We will get those later.
In 1974 Republic 2.1 per cent, Northern Ireland 3.8 per cent; 1975 Republic 2.3 per cent, Northern Ireland 4.1 per cent; 1976 Republic 2.7 per cent, Northern Ireland 4.1 per cent; 1977 Republic 3.2 per cent, Northern Ireland 4.6 per cent; 1978 Republic 3.6 per cent, Northern Ireland 5.0 per cent; 1979 Republic 3.9 per cent, Northern Ireland 5.1 per cent; 1980 Republic 4.5 per cent, Northern Ireland 5.5 per cent; 1981 Republic 5.0 per cent, Northern Ireland 5.3 per cent; 1982 Republic 5.1 per cent, Northern Ireland 5.6 per cent.
Now, unfortunately, we are higher.
The sources are the London Office of Population Censuses and Surveys 1974-82 Abortion Statistics, and the percentages of total live births calculated by the Central Statistics Office, Dublin. As temporary residence in England and Wales may sometimes be stated instead of true usual residence, figures in the table may be incomplete, according to the Office of Population Censuses and Surveys, but I would make the point that that applies equally to Northern Ireland as it does to the Republic.
I have here statistics relating to sexually transmitted diseases notified to the Department of Health in the Republic of Ireland and the Department of Health and Social Security in Northern Ireland, selected years and rate per 1,000 in 15-64 and 15-65 age group, for four years. The reason that I have those four years is that the statistics for those years were immediately available in Northern Ireland, and in the short time available it was impossible to get other years. For 1974 in the Republic 1.0 per 1,000, Northern Ireland 3.4 per 1,000; 1978 Republic 0.9 per 1,000, Northern Ireland 4.7 per 1,000; 1982 Republic 0.7 per 1,000, Northern Ireland 6.9 per 1,000; 1983 Republic 1.0 per 1,000, Northern Ireland, 7.7 per 1,000.
On a point of order, could the Senator indicate the relevance——
An Leas-Chathaoirleach
The Cathaoirleach has already ruled before I came into the Chair, Senator McDonald, that it was relevant to the section.
I have almost completed the figures. For the Republic of Ireland the figure for 1982 relates to Dublin only minus Dr. Stevens Hospital and for 1983 the figure relates to Dublin only. In their Quarterly Report in Vital Statistics the Central Statistics Office state that notification of infectious diseases is incomplete and varies from area to area. The Department of Health say that for reasons of confidentiality GPs may not report STD cases to the Director of Community Care. Figures mainly reflect attendance at clinics. Even allowing for that, the figures for Northern Ireland are well above the figures here.
I did not quote those figures in order to show up the position in Northern Ireland or be critical about it, but it is important because the Minister, Deputy Barry Desmond, was wrong in what he stated in his speech at the beginning of Second Stage and when he was wrong in that there is a very strong likelihood that he was wrong in many other areas. I understood him to say that he and the Government responded to a situation where many people, big numbers, are concerned. I would like to extend that logic, as I think I am justified in doing, and say that we have a growing figure of abortions and if we extend that beyond the years I have here, the figure is growing all the time. The same logic would say that if the Minister had the power he would introduce legislation to legalise abortion. I think that it is proper and logical to come to that conclusion. It is the same thing. The figures are there.
For Heaven's sake.
That is distortion of the facts and an insult to the Minister.
I think it is right. It justified those who feared that something like that would happen because at the time I stated here in this House that I felt there was no need for the amendment then, but some felt that it was necessary. They were right and they had something to fear. From the figures I have quoted it is clear to me that I am doing no injustice to the Minister to state that he would, if he could, introduce legislation for induced abortions.
Many speakers in this House made forecasts about dire consequences if the pro-life amendment was passed. None of them came to fruition. I would also like to think that their forecasts about this legislation are wrong and that those of us who see dangers in it are right and quite justified. I would like the Minister to respond to that.
Before the Minister of State replies I would like to clear up a few points in relation to statistics. I made my living for quite a while teaching a form of sociology that relied on statistical surveys and the interpretation of statistics. I have retained an interest in medical statistics. I would like to put the record straight before we go any further.
In my Second Stage speech I said it behoved those who suggested connection between these different facets of what they would see as the moral collapse of society to demonstrate the connections. This has not been done in what we have just heard. What we have heard have been figures that have been attributed to the United Nations Health Organisation, sources which are somewhat dated. Most important, they are separated and not connected with each other, which misses the point that they are being asked how one form of behaviour impacts on another. We can do this only by longitudinal studies and case studies, but we have not heard any evidence of this kind.
In so far as there is a blatant inaccuracy in what we have just heard, and it affects Northern Ireland, I want to correct it. At the end of 1983 we had 263 more abortions in the Republic than in Northern Ireland. The abortions in 1983 on a preliminary estimate by the Medico-Social Research Board in answer to an inquiry addressed in December 1983, were Republic, actual 3,677; Republic expected at Northern Ireland rates would be 3,414. The difference is 263. If we had Northern Ireland rates we would have had 263 fewer abortions in 1983. We had in 1983 a higher rate despite the form of the law in the Republic.
I would ask Senator Fitzsimons to ponder on the implication of that. Examination of the figures reveals that it is important to break these figures down by age group for both parts of this island. For example, in the age group 15 years to 19 years the Northern Ireland female population in 1981 was 68,806. The Northern Ireland abortions were 415. Age group 20 years to 34 years, 154,214; Northern Ireland abortions, 896. Those between the ages 35 and 50, 124,107, number of abortions, 147. The Republic population for the same years, 1981, for the ages between 15 and 19, 159,752, if we had the Northern Ireland rate we would have had 963.5 abortions. I could give the remaining figures, but below the age of 20 there are higher rates for abortions in Northern Ireland than in the Republic — probably attributable to the fact that more people keep their babies in the Republic than in Northern Ireland. However, the statement cannot be tested except in further research. I will repeat slowly for Senator Fitzsimons: over the ages of 20 the rates were considerably higher for the Republic in 1983 on the preliminary results available. This is under the present form of the law as it exists in the Republic. If the Republic had the same abortion rates as occur in Northern Ireland I repeat we would have had 263 fewer than we had in 1983.
You have to take into account not only the circumstances of the law but also the circumstances under which the statistics are gathered and the circumstances in which people go to have abortions in Ireland. It ill behoves people to present evidence that is factually wrong in relation to the idea that Northern Ireland is a society under moral collapse. I repeat my point in two sentences. The connections between the statistics that were quoted have not been established, and they have not been established by anybody outside this House. It is a hysterical hike to the argument. It is dishonest in relation to the picture it presents of Northern Ireland.
The second point is that the statistics available for the Republic of Ireland give us grave cause for concern because our higher figures for abortions in 1983, abortions that are taking place in an atmosphere of having to break the law and in all the social isolations and difficult circumstances, give us much to worry about, without we attempting to deny it and to twist the figures for Northern Ireland to justify an argument here in this House.
I agree with the point raised by some Senators in relation to section 11 of the 1979 Act. That can create certain difficulties. I would like to pose the question in reverse. Should a health board decide that, exercising the conscientious objection which they may have a right to exercise, they would not provide a family planning service, will a person employed by the health board, in reverse, have the right to operate conscientiously, positively, by virtue of the provisions of section 2, subparagraph (i) (III) because he is an employee of a health board acting as such and the sale is made at a health institution? Is it open, in other words, to an employee of a health board, exercising his or her conscientious objection positively, to operate against the decision of a health board not to provide a family planning service?
Section 4, subparagraph (i) provides:
(II) he is a registered medical practitioner and the sale is made at a place where he ordinarily carries out his professional duties, or
(III) he is an employee of a health board acting as such and the sale is made at a health institution, or
Do these provisions prohibit sale elsewhere? If these provisions prohibit sale elsewhere, then they would prohibit sale by a doctor at some place other than his surgery. Doctors frequently see patients elsewhere than at their surgery. My experience is that social workers employed by the Western Health Board in particular frequently have occasion to advise a family on family planning matters at the home of that family. The advice given is frequently tendered at the homes of people who do not travel to a health institution. Can a sale take place at a home? If this Bill is to operate in a practical way it would necessitate sales taking place at people's homes in many circumstances, because frequently it is there that the kind of advice which this Bill would necessitate would be given, and not at a health institution. If this Bill, as worded and before this House now, operates in relation to health boards, it would appear that sale, cannot take place other than at the health institution. That would be a departure from practice in so far as that currently family planning advice is given, officially or unofficially, by social workers employed by health boards.
I have two brief observations with regard to what Senator Higgins has said. I did not state that the figures for Northern Ireland were higher than in the Republic. It was the percentage of total live births that I compared——
In 1983 they were higher for the Republic.
I have only up to 1982. The reason for that is the lack of time at my disposal to get more figures. I thought that the Minister with the resources of the Department at his disposal would have provided those figures. I want to make it clear that I did not state that the numbers were greater. I am talking about the percentage of total live births. That is the comparison I am making. I would also like to state with regard to statistics that I am not an expert in this area, but I qualified my use of statistics on Second Stage by stating, in regard to two lines of statistics, that I did not claim there was a direct cause or effect between the two of them.
That is my point.
I underlined that by stating the general way this is considered. In the summertime the number of drownings goes up. The consumption of ice cream also increases, but nobody would claim there is a direct connection between the consumption of ice cream and drownings.
(Interruptions.)
The consumption of ice cream has nothing to do with family planning.
In fairness Senator Fitzsimons is talking about accidental connections and causal connections but he has not established his case that there is any connection between the availability of contraception, abortion, the collapse of society, venereal disease, ice cream or anything else.
My basic reason for using those figures was in relation to what the Minister stated.
An Leas-Chathaoirleach
The more we go on the more I am convinced the vote was wrong this evening. All of us are tired. It is tomorrow morning, when we are cool, calm and more rested that we should be taking this Committee Stage. We are all being funny.
With reference to that, I never saw the Members on the benches opposite in such a jolly mood as today. It is the same as if they were comedians performing throughout the debate and indeed not treating it with the seriousness they should.
That is unworthy of the Senator.
Perhaps it is the late hour. The reason I used those statistics was that the Minister in his statement was wrong. I am saying that other things follow. The further statements he made must have a question mark after them and also in relation to abortions. If the same logic is applied, and if the Minister had the power, he would introduce legalised abortion.
On a point of order, it is extremely unfair to this side of the House who support the Minister to make a suggestion of that nature.
Did I hear Senator Fitzsimons in some way suggest that the Minister, if he had the power, would legalise abortion? Senator Fitzsimons is a person I respect enormously and a person I do not like to get entangled with. I have no great brief for the Minister. He is more than capable of defending himself. It was a disgraceful remark to make. I say it as a person speaking from the Opposition benches. There is not a scrap of evidence in anything the Minister has said to suggest that he would legalise abortion. It is a very unworthy remark and Senator Fitzsimons should withdraw that remark.
(Interruptions.)
I was here when Senator Fitzsimons made his speech and I listened to it very carefully. He made an allegation and I challenged him at the time that the abortion rate in the Republic was lower than in Northern Ireland or, if you put it another way, that the abortion rate in Northern Ireland was higher than in the Republic. I challenged him and said that is not true. The Minister in his speech made a passing reference to the fact that sadly we now have a higher abortion rate than in Northern Ireland. An intelligent commentary on those figures has now been given by Senator Michael D. Higgins in response to what Senator Fitzsimons said. Notwithstanding that, and disregarding the fact that his whole case has been put in question and has been shown to be completely fallacious, Senator Fitzsimons not only persists in a case he cannot sustain but then makes a totally unwarranted, unfair and unchristian allegation about the Minister.
I will simply say that the figures are there to be challenged by somebody who is more expert with figures than I am. They are on the record of this House. The implication——
An Leas-Chathaoirleach
The Senator could have made his point without the reference to the Minister, which quite clearly has upset his colleagues on the Government side. Would the Senator kindly withdraw his remark because Senator Robinson and Senator Brendan Ryan feel the Senator has made a specific allegation against the Minister for Health? Would the Senator withdraw it please?
Could I put in this way? If it is felt that my conclusion is unreasonable then I withdraw it?
It is so felt.
I hope the Senators are satisfied with that.
I certainly will not go into the same long expression of opinion on statistics as Senator Fitzsimons or Senator Michael D. Higgins did. There seems to be some battle there about statistics. I do not know what they are quoting from. Although I am aware of what Senator Higgins was quoting from, I certainly am not aware what Senator Fitzsimons was quoting from. I have to take the word of Senator Higgins that the figures are unsustainable.
You can do anything with figures if you manipulate them around. I will quote just one figure. It is from the Register General in Northern Ireland in relation to the rate of abortions per 1,000 women in Northern Ireland aged between 15 and 44. In 1982 it was 4.61 per cent and from the CSO here it was 5.10 per cent. I am not trying to say that as a result of these figures people should make up their minds one way or the other. I am quoting the figures, because this was something mentioned by Senator Fitzsimons.
I refer the Senator to section 10 of the 1979 Act which states: "Nothing in this Act shall be construed as authorising the procuring of abortion". That is the Act which this Bill is amending and which was brought in by the leader of Senator Fitzsimons's party. The Senator has withdrawn the allegation he made against the Minister for Health. I would refer the Senator to an interview done by the leader of his party in Hot Press where he indicated he would like to do a lot of things to a lot of people if the opportunity was given to him.
With regard to the implication of the Senator's opinion as to why the Government brought in this Bill, I refer to my reply on the Second Stage. The Government were convinced of the necessity for a change in the law on the lines proposed. This necessity arose for a variety of factors to which I drew attention on Second Stage. The evidence of sexual behaviour inside and outside of marriage pointed to the need for a legal framework for family planning which makes a realistic response to the needs of people.
Senator Durcan raised one particular point in relation to the outlet. The outlet has to be in accordance with what is stated in the Bill, from the place of business and not from the home. If the home is the place of business that would be acceptable. He also raised a query as to the position where the attitude of one employee differed from that of the rest of the staff.
Would that employee be bound to obey the health board authority?
He would not, depending on the circumstances.
The Minister of State did not answer the question that was raised by Senator Durcan who asked a specific question as to where did the responsibility of the health board employee start?
The question I raised was answered by the Minister. I do not know if Senator Lanigan was here when I asked that question.
I was here when it was answered.
We have dealt with a number of important issues arising out of the section. I would like to turn specifically to the extent to which the section relates to opening up access to contraceptives which I have indicated I believe to be necessary and important. I know it is not the Minister's fault. He has been trying to answer the points that have been raised. I come back to the question — which he was trying to answer when he was sidetracked, through no fault of his own — as to the information available to us. He was about to tell me that the review is absolutely not available to us. He was curtailed in saying that.
That is correct.
The Minister, nonetheless, on Second Stage, gave some indication of the information contained in that review. If we cannot have that review, for whatever reason, maybe the Minister will tell us why. At least, let us advert to the pieces of information we have on it.
Could I say in relation to the review that departmental internal reviews are generally used for internal purposes only. The information I have supplied is all that I can give.
Could we ask the Minister to repeat what he has said?
Inter-departmental reviews are available within the Department for the information of the Minister.
It comes back to freedom of information. Legislation has to be implemented. We will have to gain access to this information some day. However, working with the imperfect tools and knowledge we have, the Minister on Second Stage referred to the fact that the review indicated that approximately 30 million condoms were imported and sold over the period since November, 1980. He stated:
The review also indicated that they are being sold in just over one-quarter of chemist shops and the family planning clinics, which were few in number.
It would be helpful to us in trying to assess the importance of section 2 to know from the Minister what the locations of the one-quarter of chemist shops are which are at the moment selling contraceptives. I do not want the precise location of every single chemist shop but could he tell us that there are a certain number in the various cities and towns around the country and, more specifically, could he give precise information to the House of the areas and regions where there are no chemist shops supplying and selling contraceptives?
When we know from pieces of the review which the Minister has now in his possession what the information is on the question I have asked I would like him to indicate whether it is his opinion and that of his advisers that the provision in section 2 (1) of the Bill will extend the number of chemist shops which are likely to sell and offer for sale non-medical contraceptives. It could be that the Minister will not have any views on it. It may be that there is no way of assessing this. It is important for us to know whether it is anticipated that more chemist shops will be likely to stock and sell non-medical contraceptives as a result of this legislation.
It is anticipated that more pharmacists will stock non-medical contraceptives. Looking at this map, I would like to make a few comments. There are areas in the west and in the south where there is quite a discrepancy in relation to the rest of the country as to availability of contraceptives.
There is information and information. Most of us know that map exists. It would be helpful if we had that map in front of us; we would be much more informed. At one stage it was published in the national newspapers. However, we do not have it as part of our background information briefing on this Bill. Could the Minister be specific as to the areas in the west and south? I have a great interest in the west where I come from. I identify with women, in particular, west of the Shannon. I would be very interested to know in more specific terms about the availability of contraceptives.
In west Mayo in particular there is an area between Belmullet, Ballina and Castlebar where there is a lack of outlets.
Total lack of outlets?
Yes, but in the places I have mentioned there are outlets. It is in the areas in between those towns that there are no outlets.
There is no doctor there.
Doctors cannot provide contraceptives in their present role. It would be fair to say that in the east Mayo area there is a lack of outlets. In the west Galway area there is certainly a lack of outlets. There are outlets in Clifden and in Galway but in between there are no outlets. There are certain problems in the east Galway area.
Oughterard is badly serviced.
It would appear so. In the south-eastern Kerry area and in particular the mid-Cork area there are no outlets—this is just a rough glance—and in the Tipperary and Westmeath areas and one would not be totally enamoured with the situation in Waterford. All County Roscommon is an area where it would appear that there is a need for more outlets. The same would apply to Sligo, Leitrim and Donegal. This is roughly the number of areas where there is a lack of outlets.
I am grateful to the Minister for this indication. Perhaps, if this is tolerable within the constraints of confidentiality in the Department, we could after this debate have more precise information on it.
A press release.
Could we have the precise outlets circulated to Members of this House? We cannot assess the scope of section 2 unless we are informed on this. There are two questions that arise from the Minister's reply. I appreciate he is giving us useful information on which to form an assessment of the appropriate section. The first question is, what is the basis of the Minister's affirmation, at the start of his contribution in answer to my question if the provisions of section 2(1)(i)(I) of this Bill will definitely lead to an increase in chemists' shops who will stock and make available non-medical contraceptives?
The second question I would ask the Minister of State is, how can he and the Minister for Health reconcile the very uneven and very discriminatory pattern of access to chemists' shops for the availability of non-medical contraceptives with the obligation on the Minister under section 2 of the 1979 Act to secure the orderly organisation of family planning services? How is the situation where there is an absence of access in whole regions of the west, the south, the midlands and where in certain other areas there are gaps in the access to contraceptives, in a situation where doctors, under the present law, may not sell contraceptives, where a person, therefore, is dependent on chemists' shops for access to non-medical contraceptives, to be squared with the duty on the Minister under the 1979 Act to provide for the orderly provision of family planning services? I would be grateful for an answer to those questions.
The Minister is not satisfied. That is basically the reason for the Bill. As I have already stated in answer to Senator Higgins, the Minister can direct a health board, under section 6 of the 1979 Act, to provide the services within an area if they are not already there.
What is the basis of our confidence in the fact that chemists who have not availed of the opportunity to sell contraceptives before should do so now? We think the Bill will be an impetus to them to go ahead and do that. It would be fair to say there has been a small but steady increase in the number of outlets where non-medical contraceptives are available. There is a continuing rise in that direction over the years.
On Second Stage, I referred to the 18 years specified as being spurious. Many other people have made the point since that there is no way the availability of contraceptives can be confined to persons over the age of 18. Common sense will tell us that it cannot be confined to persons over 18. The Age of Majority Bill was introduced to give credence to this.
This is a completely different situation from that where a contract is drawn up. As far as the age of majority is concerned there is time to have the contract signed, there is time to submit birth certificates, there is time to check. When somebody calls in to purchase contraceptives there is no time for checking. Why are contraceptives being distributed or sold through medical outlets if they are non-medical? Those in chemists' shops are not in a situation to be able to decide a person's age. Some people would say that licensed vintners, who have a responsibility towards those under 18, would be in a better position. I am not saying they should be sold through them. People would claim that perhaps they would be in a better position because they have a responsibility not to sell drink to persons under the age of 18. In the principal Act contraceptives could be sold to persons under 18 years. Now we have a situation where boys and girls can get married at 16 years but apparently they cannot avail of non-medical contraceptives until they are 18 years of age. Is there not some inconsistency here?
I want to come back to the question of pharmacies. I raised the question about pharmacies which are actually limited companies. A number of comments have been made to me that because of the formula of words used in the principal Act and retained in this Bill, pharmacies, which are limited companies, are precluded from the sale of contraceptives. I know it has been stated by a number of major pharmacies in the city of Cork that they do not feel they are legally entitled to stock and supply contraceptives for sale because they are limited companies. Perhaps the Minister can clarify this.
We have no representations from any of the companies the Senator referred to that they be included. This is only a limited Bill. The Minister felt there was no need to widen the scope of it in the direction as suggested by Senator Ryan.
The Minister, presumably, has better advice available to him than the sort of advice I get from my own somewhat ineffective imagination at 12.20 a.m. Does the principal Act make it legal for pharmacies which are limited companies to sell contraceptives?
It is illegal.
I have a supplementary question. What is the rationale for such illegality? Why are limited companies not allowed to sell if they are operating a pharmacy in the ordinary way?
There is the personal responsibility in relation to the pharmacy in question.
It seems to be a ridiculous situation.
It is illegal for the person selling contraceptives to sell to persons under 18 years.
This is the area that has annoyed so many people and worried so many parents. It is no harm even at this late hour, to refer again to the fact that in legalising the sale of contraceptives to teenagers we could not but give the impression that promiscuous sexual indulgence by them was socially acceptable. That is how the young people would see it.
The Minister has referred to the scarcity of outlets throughout the country. It goes back to the point made by one of the Fine Gael Senators, about the lack of demand for this section. To have it in the Bill is an insult to our youth.
I accept the point about the age of majority. I accept that some of our youth are using contraceptives. I accept the point that they can join the Army. Yet, I feel our youth are in some way insulted by this Bill. The youth are preoccupied with other important matters. One would imagine that the only thing that mattered to them was a Bill providing contraceptives. We know from the Costello Report that the priorities of people between the ages of 14 and 25 were having good health, a job and for peace in the world. The problem of contraceptives was so far down the list that it certainly did not count with them. I have to ask, when there was clearly no demand, why insult the youth of Ireland as if this was the only problem that mattered when so many other matters were in fact on their mind?
As I said before the regime of controls that we are imposing would suggest that we were dealing with an infectious disease rather than something that is part of the normal life, of what I suspect is the majority of married couples in Ireland today. One gets the impression that people should run away and hide when they dare to mention contraceptives. I find it quite astonishing that the question of personal responsibility, which is probably the best answer that the Minister could produce at short notice, should be introduced because there are a number of other areas where the question of personal responsibility does not seem to matter. For instance, the family planning clinics most of which would, if they have any sense, be limited companies, are actually going to be selling contraceptives under identical conditions to those of a pharmacy and they do not have to have this element of personal responsibility because quite obviously we do not have family planning clinics that are run by individuals; they are run by organisations. But we are told now that pharmacists and pharmacies must have this element of personal responsibility. I think the Minister can do better than that or else he can concede that it is something that they did not think about, and hopefully we will find some way of getting around it.
On the question of our young people, there are two factors involved. First, a prominent Fianna Fáil front bencher visited my place of employment, the regional technical college in Cork, to speak to Fianna Fáil members in that college who are mostly students. They took him apart because of Fianna Fáil's opposition to the family planning Bill, because they were absolutely appalled by it. Secondly, there was a meeting organised by the student's union in my college last Wednesday, an open meeting by invitation at which the local family planning clinic were giving information on contraception. Roughly 40 per cent of the full-time student population of my regional college attempted to attend that meeting. They could not all get in because the place was grossly overcrowded. Does that not indicate, a demand for information and a commonsense approach?
What Senator Fallon quoted from the Costello Report indicates the healthy attitude that young people have to matters of sexuality and so on. It is their elders who assume that they are liable to jump into bed with all and sundry given half a chance, whereas the youth themselves indicate that sexuality has a normal balanced part in their lives and is not something that dominates their lives in the way that their elders seem to assume it does. Can we leave our young people alone? The 18-year-old-age limit is a ridiculous insult to them; it is entirely unnecessary to have an age limit in it. Our young people are, by and large, far more responsible than their elders and in fact most of what they suffer from is the irresponsibility of their elders.
Just a very brief comment on the matter of personal responsibility and limited pharmacies. It seems strange that these people are in the business of dispensing dangerous drugs and making life-and-death decisions about medication and yet because of some quirk in the legislation they are not empowered to sell contraceptives.
In relation to age, it sometimes happens — and this is a sorry fact of life — that when minors, people under the age of 18 present themselves at family doctor surgeries it becomes apparent that they are sexually active. Despite urgings to desist from such activity, which I personally think is unwise, nevertheless it often becomes clear that they are determined to pursue their relationship or relationships, so it would appear to be prudent and wise that they would be given advice in the matter of family planning. It would seem unwise to put a young woman under 18 on the pill. It is possible for a doctor in such circumstances to prescribe condoms and will such a prescription be honoured in a pharmacy?
Yes, is the answer.
I just want to follow up on two items. First, Irish Family Planning Clinics Limited are now going to continue to supply condoms. The Minister said today that a limited company cannot supply condoms.
A pharmacy.
I am sorry, what has been said is that a limited company cannot supply condoms. I want to ask the Minister, is a limited company under new legislation allowed to supply condoms or are they not? Senator Ryan mentioned his regional college and made a big play of what happened there. I addressed a function at his regional college and even though he may be a lecturer in his regional college the statements he made in relation to this Bill are totally in opposition to what the students of that college would feel.
I think I know better than that.
You are too close to the situation. You do not know.
I want to refer to the questions that were asked of the Minister of State and particularly the point by Senator Bulbulia, about the apparent fact that chemist shops that are owned and run by limited liability companies would not be authorised access points under this new legislation. I was not aware that there was this potential restriction; it is an idiotic restriction. I find it sufficiently idiotic that if it is a real problem it is one that we should deal with on Committee Stage. I do not see why we do not redress it by an appropriate amendment.
The problem seems to arise in the 1979 Act, in the definition of dispensing chemists and druggists because that specifies that a dispensory chemist and druggist means a person registered in the register of dispensing chemists and druggists established under the Pharmacy Act, 1951. Could the Minister confirm that there is a real problem with that definition? In other words, is it possible for a "person"— a natural or legal person as it is sometimes put — to include a company? Is it possible for a company to be registered as a person on the register of dispensing chemists and druggists established under the Pharmacy Act, 1951 or does that definition necessarily exclude the possibility of a company operating a pharmacy? If so, that appears to be carried over to section 2 (1) (1) of this Bill because he would be a servant or agent acting as such of a pharmaceutical chemist or dispensing chemist or druggist. Is it totally unnecessary, confining? This is not an academic point. We are not picking legalistic points at this hour of the night for the sake of it. It relates to the very real matter that we were talking about earlier and that is whether we are in a position to improve on a very patchy and very inadequate and unsatisfactory situation, on the Minister's own recognition of it, where there are not adequate access points, particularly in areas such as the south and west and certain parts of the midlands, where there are defined omissions. If, by extending the range of chemist shops we can improve on that then we should actively do it. It is important.
That may be done at some stage later on. Basically it is too complex an issue to have included in this legislation.
(Interruptions.)
Too complex an issue?
Yes.
At present if a pharmacy which is a limited company dispenses a condom it is breaking the law. Ninety per cent of pharmacies are limited companies. Could I ask the Minister if they are breaking the law?
Ninety per cent of them are not limited companies.
If a pharmacy is a limited company is it breaking the law in giving out condoms? Could I ask also are Irish Family Planning Clinics Limited breaking the law by dispensing condoms?
Irish Family Planning Clinics are not breaking the law. Pharmacies which are limited companies are breaking the law if they sell condoms. Ninety per cent of pharmacies in this country are not limited companies.
So what the Minister is saying is that Irish Family Planning Clinics Limited do not break the law by dispensing contraceptives. If a pharmacist, the normal chemist shop down the country, with a family business, decides to go into a limited company he will be breaking the law if he sells condoms. Therefore, what the Minister is suggesting is that Irish Family Planning Clinics Limited are being legitimised and the ordinary chemist's shop or whoever is dispensing down the country is now being illegitimised because they have a limited company.
For someone who has been opposing for so long the Senator is showing a magnificent interest that there should be a lot more outlets than there were previously. For so long the Senator was trying to curtail the outlets as much as he possibly could. The Senator, I presume was one of those who supported the 1979 legislation. He opposed the Bill on this occasion. What does he want?
I am asking a question. Are Irish Family Planning Clinics, Limited going to be allowed to dispense condoms when an ordinary chemist's shop down the country which has incorporated itself as a limited company is not? Is the Minister suggesting that the ordinary person down the country who has got himself involved in a limited company — the Minister will not answer the question.
Family Planning Clinics can.
The answer here is that once this Bill is passed Family Planning Clinics can legally sell contraceptives but a pharmacy which is a limited company cannot do so. The fact that Fianna Fáil are being inconsistent in looking for more outlets when they previously opposed the Bill does not alter the fact that this is a ludicrous situation and one which should be remedied. Why are pharmacies that are limited companies prevented from doing this? The answer that personal responsibility is involved is again a ludicrous answer. As Senator Bulbulia has pointed out, they are allowed to dispense life-and-death drugs; they are allowed to take decisions which intimately affect the health of their customers and they do give advice to customers on their health. Why should they be prevented from selling condoms? It seems to me ludicrous. I see no reason why we should not change that situation.
I would agree with Senator McGuinness in everything that she has said except for her attack on Fianna Fáil. The fact is that a limited company run as Irish Family Planning Clinics Limited can dispense condoms whereas any other outlet which is a limited company cannot.
I would like to ask one further question. I would agree unequivocally with all of Senator McGuinness's remarks, including her comments in passing, if the case is as she says, and I am inclined to think it probably is. But there is one area of doubt because, as section 2(1)(i) stands — it will be an amendment to section 41 of the Principal Act — it provides that a person can sell non-medical contraceptives if he is, or is the servant or agent acting as such of a pharmaceutical chemist. If there is a pharmaceutical chemist who works for a limited company but owns a pharmacy can that pharmaceutical chemist qua individual pharmaceutical chemist sell in the premises contraceptives or can he not do so because he is a pharmaceutical chemist who works in a premises owned by a limited liability company?
I think that is a subtle difference between what we are talking about, a registered chemical company and a chemist who is a registered limited company. The 1979 Act says that a dispensing chemist or druggist means a person registered in the register of dispensing chemist's and druggist's. Further down it says "pharmaceutical chemist' means a person registered in the Register of Pharmaceutical Chemists for Ireland established under the Pharmacy Act, 1875." I take it that, whatever about the company being a limited company, provided that the person working for the company at the point of sale is a registered chemist he is legally entitled to sell contraceptives. That is how I interpret it, irrespective of who he is working for provided that that person is a registered chemist. That is the 1979 Act and I presume that that is what is contained in the 1985 Bill.
I would like to suggest to the Minister of State in relation to what Senator Ferris has just said that it would seem a ludicrous situation where the only person who could dispense contraceptives in a chemist's shop that was part of a limited company would be a person qualified as a pharmaceutical chemist. It seems that the clause of conscience is most easily dealt with where you are dealing with a limited company. In fact, the onus should be on the limited company to ensure that they provide the contraceptives that the people need whereas we would have to make reservations about the individual chemist who owns a privately-owned chemist's shop and who has genuine conscientious reservations. Therefore, it seems that there is perhaps need for amendment — those who are good at drafting amendments might consider — in relation to the obvious defect in this Bill whereby shops that are part of a limited company are excluded from providing contraceptive devices by law unless these are handed over the counter by a pharmaceutical chemist. It seems an extraordinary situation, another Irish solution for an Irish problem, if I may say so.
Could we have an answer from the Minister? Who is allowed to sell contraceptives?
The point that is being made is that a pharmaceutical chemist can sell contraceptives. The question has arisen as to whether a limited company can sell contraceptives. As the Bill is laid down a limited company cannot sell contraceptives. It may be an anomaly but that is the Bill before the House.
May I say that we have arrived at a situation where Irish Family Planning Clinics Ltd. are out of business in the morning as a result of this Bill and that 99 per cent of the chemist shops who may or may not have been providing condoms to the public are out of business because it is stated specifically by the Minister that limited companies cannot provide contraceptives.
There are not pharmaceutical companies.
I beg your pardon. Every family business is now set up as a limited company.
That is not the information I have.
It is not the information the Minister has. Unfortunately, it is a fact.
The Minister clearly has information and that is what I am looking for. Could the Minister tell the House what percentage of the chemists are limited liability companies?
No, I have not that information.
Even a rough estimate for the city of Cork or Dublin?
No, we can find out, but we do not have it now.
An Leas-Chathaoirleach
There are some Senators who say they cannot hear the Minister's reply.
Could the figure be obtained for Report Stage?
Possibly.
The reason it is important that we have that information is that when we are talking about the sale by chemists, the Minister has clarified that this quite definitely, under the terms of the definition in the 1979 Act — which is now carried forward to this Bill — means that only where the chemist is an individual chemist operating as such can he sell contraceptives.
If it is a company, no.
I accept the Minister's opinion. He has obviously had advice on this. That has a very broad significance. That applies not only to non-medical contraceptives and is to some extent further amending in this Bill the 1979 Act by providing that as far as non-medical contraceptives are concerned they could be sold to persons of 18 years or over without medical authorisation. We are also talking about the sale of the pill and medical contraceptives. I regard it as extremely serious if it is the position, as the Minister now says, that limited liability companies and chemist shops cannot sell on prescription the pill or cannot make available non-medical contraceptives. I would like the Minister to clarify the position in relation to the contraceptive pill.
They can dispense the pill but they need a prescription for it.
Perhaps the Minister would clarify what the authority is to dispense the pill?
Senator Robinson asked a specific question. She has not got a specific answer. She mentioned the pill, which is a contraceptive device. The Senator asked the question: is it now the situation where only persons who are not limited companies can dispense the pill?
The pill could be classed as a medicine. As a result of being a limited company a pharmacy is in the category that they cannot dispense the pill.
Only on prescription.
Is the Minister saying that we should go back to the position that we have to pretend that the pill is a cycle regulator in order to get it dispensed by a limited company? If that is so, we are going backwards rather than forwards.
That is the point. Senator McGuinness said exactly what I was thinking. We have a philosophy in all of this Bill that this is a new, liberal law. We now find ourselves in the situation where it is confined to the few rather than to the many.
(Interruptions.)
Distribution is confined to the few rather than the many. In a limited company, under the Companies Act, a practising pharmacist is the person specifically who can dispense it. Instead of the chemist going about his daily business, doing the more important medical work, he would have to stand at the counter in order to comply with this new, liberal law, and will have to hand out all the millions of condoms so freely given by the Government. I am amazed at the situation where people with this qualification are giving out something so genuinely described as the new liberation for society. Four or five persons in any major town will be confined all day to catering for the massive use of this piece of equipment. It makes a joke of the Bill and of the thought behind the Bill. As I said earlier this legislation is being introduced at this time to divert public attention away from the reality of what is happening outside.
(Interruptions.)
An Leas-Chathaoirleach
Would Senator Lanigan resume his seat?
I agree with the Leas-Chathaoirleach. It just shows the thought that went into this legislation: all this should have been thought out. We are now placed in a ridiculous position. We have time tonight for the Minister to bring in an amendment whereby we could, by a vote of the House, take him and his party out of a dilemma.
What amendment is the Senator proposing?
The Government have brought in legislation which sounds quite stupid, which means that practicising pharmacists must attend the counter and must know the person.
No, no.
Only a practising pharmacist who is not a member of a limited liability company——
An Leas-Chathaoirleach
Senator Killilea cannot have a chat with those in the back seat while I am in this Chair.
I am not having a chat; I was interrupted. Would the Minister explain how he will overcome this situation that has been created? What will happen in the case of a rural town where there are three pharmacies, two of them limited companies and one of them private? In the two limited company shops does the practising pharmacist have to stand at the counter in order to comply with the regulations under this Bill?
I would not for one second suggest that the Minister should dream of introducing an amendment at this stage in order to facilitate my opportunist friend in front of me in attempting to return this Bill to the Dáil so that they can have further sport at the expense of the women of Ireland. There is need for a remedy, which is to introduce further immediate and urgent amending legislation. We can be assured that in this case Fianna Fáil will support it, judging by the concern expressed here.
(Interruptions.)
Senator Killilea's question is the one I asked. Senator Ryan has provided the answer, that there is need for amending legislation to ensure that limited companies can prescribe contraceptives for those who need them.
Yes, but when the Bill is not in itself absolutely perfect and when it is against a certain section of the community there is a constitutional problem. Here and now is the time to adjust it, before the Bill is passed, rather than take the soft option given by Senator Ryan. If one is bringing in legislation one must make every effort to bring it in so as that it complies with the Constitution.
On a point of order, it is disorderly for the occupier of the Chair to refer to the absence or presence of a Member of this House. I ask the Leas-Chathaoirleach to withdraw the remark that she passed a moment ago.
An Leas-Chathaoirleach
I have no intention of doing so. It was your continued interruption——
On a point of order, if I was absent I could not have been interrupting as you suggested.
(Interruptions.)
I want to make one further comment on the matter we have been discussing and then move on because, although there are spoiling tactics going on, some of us are actually concerned about the merits of this Bill and are anxious to give it a genuine Committee Stage. It is not our fault that we are constrained to do it at this early hour of the morning.
The Minister said that in so far as pharmaceutical chemists who are limited liability companies are concerned they can dispense the pill on prescription. He stopped there. They can do it on prescription as a cycle regulator for medically indicated reasons. They cannot do it under the definition in the 1979 Act as a contraceptive. Therefore, we are on to double-speak, double-think, double-do. We are on a fudge again. It is important because we are having a genuine Committee Stage on this Bill to register dissatisfaction with the fact that the outlets in subsection (1) of section 2, in so far as they relate to pharmaceutical chemists, are seriously defective. They do not extend to a limited liability company and ensure that it could, as chemists will be able to when this Bill is passed, sell non-medical contraceptives to those of 18 years and over. They cannot even sell medical contraceptives, in other words, the pill unless they do the fudge that it is not a contraceptive. That is very serious socially. It is undesirable and a serious omission in the drafting of this legislation. However, the reality is probably as outlined by Senator Brendan Ryan.
I want to move on to another aspect of the question of determining the proper outlets and to have better information than that provided in a limited way by the Minister in his opening speech on the next category of dispensers of non-medical contraceptives under this Bill. Section 2 (1) provides that registered medical practitioners can sell non-medical contraceptives at the place where they ordinarily carry out their professional duties. Before we authorise this, I would like to be better informed on the reasons why the Minister was critical of the medical profession in his speech introducing this Bill to the House. He referred to the review which we cannot have access to. He said that while information and advice on family planning matters are integral elements of general practice, not all doctors are willing or able to provide a comprehensive family planning service to their patients. What was the basis of that? Can we have some figures on that? Can we have some further details about the unwillingness or inability of general practitioners to provide a comprehensive family planning service? I echo the view put forward by Senator Bulbulia that if we are to have the best and most acceptable family planning service then we are extremely dependent on the full cooperation, training, ability and capacity of GPs to provide that service. If we are authorising them to be an outlet for non-medical contraceptives, I would like to know why the Minister has concluded from the details available to him that there are serious deficiencies in the present operation of the service provided by GPs in this area.
Twenty per cent of doctors do not provide a family planning service. The College of General Practitioners are anxious to educate their members in family planning.
If a person is a member of a limited liability company involved in a family business or any type of operation, is that person now precluded from dispensing or being involved in the selling of condoms?
The Minister of State said that 20 per cent of doctors are not supplying this service. Has the Minister a map in relation to general practitioners? The Minister spoke about the Irish College of General Practitioners encouraging training in family planning for its members. This is very welcome. In our medical schools family planning should form part of the curriculum. I am not sure whether it does. If it does not, I would like the Minister to ensure that family planning would be an integral part of the training programme for medical students in all colleges.
I will be happy to relay the views of the Senator to the Minister for Education. As far as education and schools are concerned, while it may be something to do with the Minister for Education, it certainly has nothing to do with the Minister for Health.
Senators
We cannot hear the Minister of State.
People generally say that I speak too loudly rather than too quietly. Senator Bulbulia asked about education being provided in medical schools. I told her that it was a matter for the Minister for Education. We will relay her views to the Minister for Education. The Senator asked about a map. We do not have a map to specify the areas similar to the one we have in relation to the outlets.
I asked a specific question. I asked if there is a participating pharmacist in a limited liability company, is the Minister now saying that that person cannot dispense condoms?
We have gone over the ground again and again. What the Senator is suggesting as being an anomaly in this Bill is accepted by us all.
I did not suggest there was any anomaly. I asked a straight question and I want a straight answer.
The 1979 Act which the Senator is bending over backwards to support has that anomaly. The only difference is that it needed a doctor's prescription.
Order, please.
I asked a specific question.
The 1979 Act has that anomaly. The only difference is that it needs a doctor's prescription. Senator Robinson and others have asked the Minister to look at this anomaly. When the Senator's party leader brought in the 1979 Act he could not see the anomaly about registered chemists, limited companies or otherwise.
On a point of order, could I ask the Minister to answer Senator Lanigan's question?
That is not a point of order. Senator Ferris stood up and made a comment. He is the Leader of the House and I was obliged to listen to him. I ask the Minister of State to reply to Senator Lanigan.
A limited pharmaceutical company cannot sell contraceptives.
A limited pharmaceutical company cannot dispense contraceptives. What is a limited pharmaceutical company?
That is a different question.
I am asking a question. What is a limited pharmaceutical company?
Did the Senator ask what was a pharmaceutical company?
I asked what is a limited pharmaceutical company? Will the sale of contraceptives be restricted to a limited group of people? Is that what the Minister of State is doing or what is he at? What is a limited company?
A company registered under the Companies Act.
If I register a company under the Companies Act——
I do not mind what the Senator does.
You will have a conscientious objection.
What does the Minister of State mean by a registered company? I want to get this matter straightened out. Obviously if he wants to make throwaway remarks he is quite entitled to. I asked a question and I want to get an answer to it.
A company registered under the Companies Act. If the Senator wants to go into that Act he better get somebody else in on that.
Who is entitled under this section to sell contraceptives?
Read section 2.
The Minister of State stated that the sale of contraceptives was confined to a specific group of people. Who are these people?
I hope what I say may prove to be helpful. We should remind ourselves that it is late, that nerves are frayed and that the Enterprise leaves at 8 a.m. I wonder if this difficulty with a limited liability company could not be overcome by the insertion of an amendment after the words "pharmaceutical chemist" on the second line of section 2 (1). I do not claim to have any legal expertise in this matter and doubtless there will be other Senators who might be able to refine what I suggest. Subsection (1) states:
he is, or is the servant or agent acting as such of, a pharmaceutical chemist,
Could we add there "or is the servant or agent acting as such of a limited liability company or a limited liability pharmaceutical company" or whatever is most appropriate? What I am suggesting is that somewhere in that clause there is need to include limited liability companies who have a pharmaceutical commitment. I would like to hear if the Minister of State feels that is a helpful suggestion.
We have had more than enough discussions about the position under the Bill. It seems clear that there is an anomaly in that a limited liability company who happen to be running a pharmacy cannot sell contraceptives. That is something that should be amended but, on the other hand, I do not believe the Government will bring in an amendment to this Bill as that would mean the Bill would have to go back to the Dáil. However, this kind of nonsense is one of the unfortunate results of the fact that we are being pressured to take all Stages of this Bill tonight and that the Minister is not present. The Minister of State, through no fault of his own, cannot undertake to bring in amending legislation on this subject as soon as possible. The Minister could do that and that might satisfy those of us who have a worry about it.
If we could have the Report Stage adjourned until tomorrow morning, it would give the Minister time to consult properly with his officials and to come back with answers to the questions that are being asked. The Minister of State naturally is not as familiar with this Bill and the background to it as the Minister. Through no fault of his own, he is being put in a very difficult position. I suggest that when we finish Committee Stage, we adjourn the Report Stage until tomorrow so that the Minister may come in.
It is not the intention to accept any amendments to this Bill but I will give a guarantee to the Senator that we will have a look at the operation of this Act and if, as a result of our review it appears that there is need for amending legislation, it is possible that we would introduce that. In reply to Senator Lanigan, I refer him to section 2 (1) which states quite clearly who is entitled to sell contraceptives.
The Minister said that if there are anomalies in this Bill amending legislation can be brought in. One of the problems in this House and in the other House is that legislation which has been brought in has been amended not alone by us but by the High Court and the Supreme Court. It is about time that we passed legislation which can stick and which Senator Robinson and her colleagues in the Four Courts cannot get at us for. When I mention Senator Robinson, I am just mentioning the fact that in the Four Courts we are criticised every day for bringing in legislation which will not stand up to the court's decision.
The Minister has stated that if there are problems we can bring in amending legislation. One of the reasons that we are here is to bring in legislation which can stick and that cannot be taken asunder in the Supreme Court, the High Court or the European Court. It is up to us tonight to make certain that the legislation we bring in can stick and it is not for the Minister to say that if there are problems we can bring in amending legislation. We have had this problem for years.
Since 1979.
Either we bring in legislation which can stick or we do not bring it in at all.
The Chair will be pleased to know that I am not going to respond or react in any way to what Senator Lanigan said. I do not think there were any insinuations implicit in it. As regards the context in which we are looking at section 2 of this Bill, I have a fairly significant number of further questions to ask. I want to do it in the context of having a proper Committee Stage. I echo what Senator McGuinness said. I am dead tired at this stage. I cannot understand why, at 1.15 a.m. we are flogging ourselves to get through Committee Stage of this Bill. I have a number of further serious points to make. As it is, we have clarified and teased out some of the important implications of this section. I want to go on doing that. I want to do it in the normal, rational way. There is no rush about this legislation. I ask the Leader of the House to think again about it. Why on earth are we flogging ourselves at this hour? There is not even any doubt about the vote. I am prepared to go until 4 o'clock in the morning, if necessary, but I do not know why I have to.
Senators
Hear, hear.
The Leader of the House is unreasonable.
The Minister of State, in reply to an earlier question of mine, referred to the fact that 20 per cent of doctors do not provide any family planning service. Is the Minister of State in a position to give the House information on an issue I raised on Second Stage and on which I expressed concern——
If Senators want to talk they should leave the Chamber. I have no objection to their talking but not when a Senator is making a contribution.
The issue I want clarification on is the extent to which those 80 per cent of GPs who provide a family planning service tend to either totally or predominantly prescribe the pill. It is clear from the Minister's Second Stage speech that this was one of the issues that concerned him. Presumably it arises from the review of the provision of family planning services. He used the phrase that not all doctors are willing or able to provide a comprehensive family planning service to their patients. I take it from that that not only would there be a percentage — the Minister says 20 per cent — who do not provide any family planning service but also that there would be a significant percentage who either predominantly or exclusively prescribe the contraceptive pill as the only contraceptive.
I would welcome any clarification which the Minister can give on the extent to which the review points to a tendency to over-prescribe the pill. This is something that may well be countered. It may, at least, in part, be helped and ameliorated by the provision of wider outlets and points of access for non-medical contraceptives. It may encourage greater use on non-medical contraceptives. This is an extremely important medical and social issue and I would like to have as much information on it as possible.
We have heard about chemists being suppliers. We have talked about health board personnel being suppliers. There is a percentage of the medical corps who will participate. Can the Minister of State tell the House if there is an area that will be left without any service? The Minister of State has maps and there is a secret review in somebody's brief case. We are not being told what is in it, but we know that there is a percentage of doctors who will not participate. I am still not clear that the Minister has power to tell a health board what to do. The Minister has not the power to order them to give a service. Where are those GPs who will not participate located? I am sure the Minister knows. Certainly his senior officials know. This House is entitled to know what area will be served and what area will not be served. There are a percentage of doctors who will not participate and the Minister has not the power to order them to do so. Many people serving on health boards have deep reservations about his power over them. After the carve-up today we do not know who will be serving on the next health boards. Will the Minister of State tell the House what percentage of doctors will not participate and how does he propose to extend this service to everyone?
I too am concerned about the number of women who are currently being prescribed the contraceptive pill, many of them because doctors are reluctant to prescribe other methods or are not equipped to so do. The fact that condoms will become more readily available as a result of this legislation may mean that people will opt for this method of contraceptive rather than having women taking the contraceptive pill. If they hold a medical card at present, the contraceptive pill is free of charge but condoms, which might be a more appropriate method of family planning, will have to be paid for. In addition to that there will be VAT charges on the condoms. What will the VAT rate on the condoms be? I understand that it is not be possible to bring condoms in under the medical card system.
The number of the medical profession who do not wish or desire to participate in this scheme should be made known. There are three or four different ways of registering. Will a practising pharmacist who will be operating under a registered trade name, for example, be allowed to sell contraceptives as against a practising pharmacist registered under the Companies Act? On the question of amending legislation when we, as legislators, find an anomaly and a fault in legislation it behoves us to correct it. The argument of not wanting to send it back to the Dáil is a petty one. From all we have heard throughout the debate on this question and under this section it seems that we have found a serious anomaly. We are drafting legislation which under the Constitution is against a certain section of the community. We are not supposed to do that. Due consideration must now be given to that attitude of the legislators. I would like to be recorded publicly as saying that since the theme of the debate for the last two weeks has been that we are confirmed legislators at this stage, that we should legislate properly. Whether we go on into the night or, as Senator McGuinness and Senator Robinson said, be sensible and stop this nonsense at this hour of the night, if we are confirmed legislators then our job is to legislate correctly. We blame others for interference. This measure has been the hanging hat. It has been debated profoundly on all sides. It is not good enough to slip it by, saying that we will bring in amending legislation and amend it. When?
At the same time we are legislating against a section of the working community who earn their keep from it. We have deprived them of that right while we broaden the rights of others. This Bill will be challenged by that section of the community because they will be a very powerful lobby now. If we are to amend this section we would be wise to amend it here. This is the place to do it, and if it must go back to the Dáil for a day or an hour or whatever it takes, let it, but let us be correct in the job that we are doing. It is fundamental to our job, our post or, as one might call it our profession— it is very hard to define what it is. A legislator is a working person here doing his very best to legislate.
At this hour of the night it is a sentence.
What harm? We have been sentenced in our profession to far later hours than this at night at our business, not in the Houses of the Oireachtas, but in order to prepare ourselves to come into the Houses of the Oireachtas or to be thrown out of the Houses of the Oireachtas.
I would prefer the Senator to get back to the section.
I will, indeed. That is why you, a Chathaoirligh, a very reputable and fair minded person, can see exactly the point I am trying to make. We should try at least to be as good as we possibly can in presenting a Bill to send to the President for signature. I would like the comment of the Minister on that aspect and the other two points I have mentioned.
Senator Robinson looked for information and statistics about the pill. We have none in relation to private practice but the GMS estimate that 40,000 to 50,000 women take part in the GMS. Senator Honan raised the question about the 20 per cent of doctors who do not take part in it. We cannot locate exactly where these people are. I am informed that the cost of condoms is £3 to £4 per dozen and I do not know the rate of VAT applicable to the items. I do not know whether that information is reliable.
I could not hear what the Minister of State said about the rate of VAT.
I have no knowledge what the rate of VAT is.
Does the Minister of State know whether they are to rated as luxuries or necessities for the purposes of VAT?
I do not know what the rate of VAT is.
This is a very relevant point. What is the definition? Is it a luxury? I would like the Minister of State to answer my question. Is there no other answer from the Government through the Minister of State concerning the anomaly in section 2 of this Bill? Can he suggest a remedy for that before we send the Bill to the President? I claim that the Bill is unconstitutional and can be challenged. Is there no other means but that suggested by Senator Brendan Ryan, that for purposes of speed we forget about it now and bring in amending legislation later? It is wrong to suggest that.
There is no doubt at all that Senator Killilea latched on to this as a result of an expression of opinion by Senator Lanigan and a number of other Senators here and that he is engaged merely in delaying tactics. I said to Senator McGuinness and a number of other Senators that as we see the operation of this Bill as time goes by and amending legislation seems necessary the Minister will examine it seriously, as he has looked at this legislation, and probably introduce amending legislation.
This is not a matter of me latching on to anything, it is a matter of fact. We have acknowledged here tonight that this part of this Bill can be declared by a certain section of the working community in this trade to be unconstitutional because it deprives them of the right to participate. It is not good enough. I did not latch on to it. I was the first person who suggested that it might be unconstitutional, and I think Senator Robb will agree with me. That sort of an answer, personalising the thing, saying I am latching on to something is not good enough.
I withdraw the remark if it makes the Senator feel any better.
The Minister of State's hassle has not been with me this evening. We deal with matters relevant to ourselves in a different way but we are dealing with the Houses of Parliament now. It is not good enough that a Minister of State representing the Government and the Minister for Health here tonight would say, yes they acknowledge that something is wrong with this Bill and it is unconstitutional. That is what he has said, and that being so the matter should be taken further.
The more we go on and talk about this the less credibility we will have as legislators. Section 2 is being teased out. Some Senators think this amusing. The time is 1.30 a.m. We now find that people specified in subparagraph (i)(I)(II) and (III) will not be full suppliers.
That is unconstitutional.
Surely that is unconstitutional. The Minister made a passing reference to the question I asked about the doctors. The Minister for Health in his speech on 27 February said that the Seanad would be aware of the statement by the chairman of the Ethics Committee of the Irish Medical Organisation on 11 February, and that he believed that doctors generally would welcome the Bill and that similar sentiments had been expressed by the Irish College of General Practitioners. That is fine, but I thought that when this Bill was brought in by the Government everybody was going to have some family planning service. The more I listen to replies to questions that have been asked by my colleagues and myself the more convinced I am that section 2 is unconstitutional.
Sometimes I feel that raising the suggestion that it is unconstitutional is the last resort. I will not rise to that at all. I want to get back to the context in which we are seeking to change and expand the accessibility of contraceptives. The Minister in replies to earlier questions mentioned that approximately 40,000 to 50,000 women are on the pill under the general medical scheme. He had not really answered the other question. I am not sure if he is in a position to, but if he is I would welcome some comment as to whether the review disclosed an over-prescription of the pill in comparison to other contraceptives, or an imbalance in the method of prescribing. Like Senator Bulbulia, I have a personal concern about that.
In that connection, we have tended to concentrate in the approach and even in the jokes on this Bill on the fact that it will provide for greater access to condoms. It also provides for access to spermicides. In that connection, perhaps the Minister would indicate to the House the types of spermicides and the types of contraceptives to which they would relate. In other words, I take it that this would also improve the likelihood of the diaphragm being described as a female contraceptive and that the spermicide is available to 18 year olds or over with no need for medical authorisation in that regard. It would be helpful if the Minister could give further details on the scope of that.
I would also like him to respond to my earlier point on whether the pill, in the estimation of the Department based on the review carried out, is being overprescribed and whether there is for that reason, an imbalance and underuser of other methods of contraception, particularly other methods for the female apart from the possibility of extending the use of condoms.
The Minister, Deputy Desmond, stated in the other House on 21 February that the failure rate for condoms was 9.6 per cent. The British standard for condoms is 3704 — 1979. It is a specification for rubber condoms made from rubber latex and intended for single use. This description was from the 1975 year book. I have not been able to trace the standard for spermicides. There is no Irish standard for either condoms or spermicides.
It might be as well.
Section 6 of the 1979 Act covers manufacture and the Minister has power to make regulations under that section and also under section 5 (4) (a). It seems to be the only means of control. I would like to ask the Minister, do any conditions apply at present or are they intended? Are there any regulations under section 16 (1) now? If not are any intended?
Senator Browne, and I hope he will clear the air.
At this hour of the night we need some form of contraception in the Seanad. Is it possible to continue all night asking hypothetical questions about what doctors will do and what people might do?
I object to that. We are trying to have a serious Committee Stage debate. It is no fault of mine or of some of the Members of the House that we are here at this hour. I would take exception to that point being made. It is unfair.
I agree entirely with the Senator.
When I explain what I mean the Senator will realise that I was not talking about her at all. We can go on talking about what will happen in the future with this Bill, whether doctors will do this, how many will do that. Maybe the people will not use contraceptives. We do not know. If we rely on hypothetical questions we could be here until Doomsday and we will all be found asleep in our seats.
I make a further appeal. I would like more sanity in the proceedings of this House. In my short time here it has been rare for Senators to plead fatigue in an effort to try to adjourn for the time being a debate on Committee Stage where there is no immediate urgency in terms of hours, days or possibly weeks to have this debated. On a more human note, our Front Bench spokesman on Health brought his little daughter to Dublin today to purchase an outfit for her First Holy Communion and she has been sitting in the Visitors Gallery for some time. As we go on into the night it is more likely than not that what Senator Browne is trying to avoid will actually become exacerbated. It is absurd. We should once and for all adjourn the debate tonight and decide to meet on another day to complete our deliberations. It is clear that the Minister of State is quite tired. He has been there for a long time under a fair degree of pressure. The same can be said of his officials and everybody concerned. I do not think if we are to continue into the night that we are going to do any service to the House or to this Bill.
With regard to some of the points which were made, castigating Fianna Fáil for their contributions on Committee Stage, Members should realise that when Second Stage was completed a vote was taken which was carried. The obligation on Senators then was not to decide whether that Bill was going to survive but whether it could be improved or teased out. All sides of the House would agree that no single Member or party has a prerogative on what should happen at that stage.
I would like to add my voice and appeal to Members here tonight or this morning. The Minister has been with us most of yesterday and all night up until now, it is now 1.45 a.m., and in four minutes time this section will have been debated in Committee for four hours. It is a long time. I do not know what we are going to achieve because everybody is tired. I understand that it has been agreed that there will be a debate on the Adjournment. Are we being fair? Is that debate still on the Adjournment? Civil servants have been waiting here for the Adjournment debate since 8 o'clock or 9 o'clock last night. Is this fair? Should that Adjournment debate take place? We have been told by the Leader of the House that the Bill must be finished tonight, that Committee Stage must be concluded, but we have not put a time limit on this debate. It is about time to start thinking a little more sensibly before some of us become stupid sitting here. If the debate on the Bill must proceed and be concluded tonight, let us agree to a time. Four hours on Committee Stage on any one section is nearly a record. It is not unreasonable to think at this stage about the hour we could reasonably finish at, giving people as much opportunity as they get on most measures going through here to tease out what they want to. Even if we sit here until 12 o'clock today I do not believe we will get any further than if we sat here until 4 a.m. It is about time we had some indication from the leader of the House as to what time we are likely to finish.
Regarding Senator McMahon's remarks, I can safely say that with the exception of half a dozen people in this House I have been around here as long as anyone else. There were times in this House when we sat for much longer than this on a section. I remind Senator McMahon that we had a debate this evening at about 9.30, on which we had a vote and it was the decision of the Government that we would continue the debate. We voted that we should postpone it until next week. Senator McMahon was one of the people who voted Tá. It ill becomes him to rise at this hour of the night and say that he is a bit tired — he is speaking only for himself.
I feel quite fresh about the matter because we have found something in this Bill which is singularly important to me. We are quite fair about it. We are teasing it out. Last week we were priest-ridden and Pope-ridden and Bishop-ridden, we were not legislators. I stand for the Republic. I am a legislator and I hope I am doing my best. We have found a great hole in this Bill. It may have shocked some of our Fine Gael Members.
A Senator
What about the 1979 Bill?
We were not in Opposition then. In my opinion it was the fault of the Opposition of that time if they did not find it. The Opposition found it this evening and it is our right to discuss the matter. It is a serious matter.
I want to refer to a statement made by Senator Michael Higgins, after the vote when he stood here on a point of order. I agree with him. He said we want to have a frank and full discussion. We all bowed our heads gently and said yes, we want a frank and full discussion. We sat down to discuss this Bill and we are doing that. I do not think there is anything wrong with that. If it goes on until 4 o'clock or 5 o'clock or 10 o'clock we are still complying with the wish of this House, as expressed by Senator Higgins. He was not opposed by any Member when he stood to make that statement on a point of procedure and a point of order. I would like Senator McMahon to remember that. He suggested that we should bring this to a conclusion at a set time. There is a word for that and if the Government wish to do that they can do that at any time. There is an apparatus called the guillotine. They can use it. We can do nothing except resist it. We must make up our minds as to how we want to finish the Bill.
This matter could be resolved quite quickly if we, as the Opposition bring in an amendment to section 2 which will probably cause a vote, unless it is by agreement. Alternatively, the Minister could produce an amendment to section 2 so that we as legislators can complete the work we have been elected to do, that is to legislate correctly so that we will not leave the matter to be brought before the courts to test its constitutionality.
It behoves all of us, including the Minister and the Government to act now. We are prepared to act responsibly. I do not purport to speak on behalf of all of the Opposition but I am sure I speak on behalf of many people. Irrespective of whether we as an Opposition have a right within that, it is our right to oppose this Bill. It is an individual right which is enshrined in our whole system. The option is quite clear. Section 2 is glaringly unconstitutional, and an amendment to it should now be produced by the Minister to resolve the problem. I cannot be party to any legislation which is obviously unconstitutional when going forward to the President.
The Seanad has a very purposeful role to play in politics because it has found within this Bill something that has escaped the other House. I ask the Minister and the Deputy Leader of the House if they would both concede to change the Bill, to amend this document so that we can have it constitutionally correct to the best of our ability. There may be some other part which has escaped our notice, but it is important to ensure that any Bill passed by the Houses of the Oireachtas is constitutional. I seek a simple answer from the Minister, with the co-operation of the Deputy Leader of the House, to advise us as to the best way to do it. Senator McMahon's problem could then be eliminated.
We are spending most of our time talking about what hour of the morning it is. If the Senator on the far side would propose his amendment and somebody would second it, we could dispose of it rather than putting this for the last hour and a half at intervals of ten minutes. The Minister will either accept it or he will not. We should not continue with this perhaps until 9 or 10 o'clock in the morning. We should have a vote on it. It is becoming rather ridiculous.
The Minister said about one hour ago that he might consider this when he sees the way it is going to operate, perhaps months or years ahead, and bring in amending legislation. We must accept that or reject it. I ask the Senator on the far side of the House to put that in the form of a proposal if he has a seconder for it, and let us dispose of that rather than continue for the next two hours, or perhaps until 10 o'clock in the morning. Let us get rid of this point which seems to be the real bone of contention at the moment.
With all due respect to Senator Lennon, to put an amendment from the Government——
It does not arise. You should know that.
To put it and to have a vote on it and get rid of it——
It cannot arise on Committee Stage of a Bill.
It is now quite clear that other Senators as well as some Senators on this side have deep and sincere reservations about section 2. With all due respect to everybody, let us get the Bill right, even if we have to sit here until 7 o'clock this morning, now that we have found that the Bill is unconstitutional.
Let me make a point to the Senators. The basic reason for this legislation is to make condoms available to people over 18 years, without a doctor's prescription.
It is almost five hours since I suggested we adjourn this Committee Stage until next week and people thought we should go ahead with it. It is now 2 o'clock and it is becoming a joke at this stage. We have the Report Stage to take after this and that will take quite some time also. I appeal to everyone, from a commonsense viewpoint to adjourn this debate now until next Wednesday.
I would like to make a point that is not contentious at all. I have listened to my colleague, Senator Robinson, make many points that extracted a great deal of information that was very valuable in regard to the health of women. In answer to the questions that she has posed to the Minister we now know about the participating pharmacies; we equally know about the proportion of medical doctors who are participating.
She has now asked a number of further questions. There is nothing jocose or time wasting about these questions. I suggest that as quickly as possible we get the information she has requested. It affects the health of women. For example, the specific replies we are now waiting for refer to the over-prescription of the pill, the use of spermicides and the whole question about women whose circumstances and whose health require the availability of other methods of contraception. I feel that we should hear the answers to those questions and we will have justified our Committee Stage yet more because we will have extracted more useful information, which is what Committee Stage should be used for. I am certainly looking forward to the Minister's comprehensive reply to Senator Robinson's questions in that regard.
Whatever about a comprehensive reply, I am prepared to say that some people are trying to get a certain amount of information and other people are trying to carry on this debate as long as they possibly can with a view to trying to upset things. In relation to the over-prescription of the pill, we have no information available in the Department in relation to that. There are three forms of spermicidal products. There is spermicidal cream, spermicidal foam and spermicidal jelly. It is a generic name for a variety of products which kill sperm.
I put some points earlier and I wonder if it is possible to hear from the Leader of the House at this stage, if we are going to have an Adjournment debate, if we could agree to conclude at some time. I will not mention a time but let us agree to a time to conclude.
The matter the Senator wants us to debate does not arise on this Bill. That is a matter for the House and the House has already regulated when that will be taken. The question of putting a time limit would, quite rightly, be interpreted as a guillotine. From the beginning of this debate I have said that there would not be a guillotine and that everybody, on all sides of the House, would have the fullest opportunity of discussing all the worries he or she might have on any section of the Bill. That is how legislation should be enacted. We are working towards that even if we are sitting late. I consider it a very useful procedure. I am thankful for the co-operation of the Opposition. I am sorry that there was disagreement late last night. We have overcome that problem by a vote of the House and we decided to go on. I propose that we do the job we were elected to do.
What about the amending legislation?
This Bill was considered in toto by the Cabinet before it entered into either House of the Oireachtas. All the elements that are being debated have been considered. The Bill before the House is a Government Bill. The Minister has indicated in the other House, and indeed in this House that there would not be an amendment to it. That does not take from anybody's right to state his or her reservations. Senator Robinson is quite right. This is where reservations should be stated and answers got. That does not mean that the Bill will be amended in any way. The Minister has given a commitment that in the event of this Bill being enacted it will be subject to review and following a review the Government then will have the responsibility to take any action that they consider necessary arising out of any inadequacies in the Bill.
The Bill is just an amending Bill to the 1979 Act. Many of the problems that the Senators have itemised on this section were in the 1979 Act. I will defend their right to tease them all out. We are here to facilitate them. The Minister was available last week to sit late to do it and the Minister of State is available now. We should not waste any further time discussing how we will go about it. We should go on until we have the job completed. I am prepared to facilitate the Opposition and any other Members of the House in doing that.
Senator Ferris said we should sit on and do the job we were elected to do. Were we elected to sit until 2 o'clock in morning? I have been a good few years in this House and only once we sat until 2 o'clock in the morning. When we were passing the Offences Against the State Act we sat on a Saturday and finished at 2 o'clock on Sunday morning. That was urgent legislation and had to be passed. This is not that urgent. I hold that it is most unfair. There are Senators who have complained to me — and they are not all Fianna Fáil Senators — that as far as their health is concerned they are not able to stay here any longer. Is it fair that we should be here at 2 o'clock in the morning discussing a Bill that could wait one week more and finish it then?
The Chair cannot help here.
I am not blaming the Chair.
My situation is that these are matters that should be discussed outside the House and agreement reached on them. I cannot do anything to help.
In my capacity as a medical person I would like to support the viewpoint expressed. One cannot expect people to have the clarity of thought at this time of the night needed for a matter of such importance to the Irish people. I beg the House to consider the need to decide that there will be a limit to the time we spend here discussing this.
That is a matter entirely for arrangement outside the House. We should now be discussing the section.
I hope these arrangements are possible.
I hope so, but it is outside my control.
Am I in order in moving the Adjournment of the House?
No.
Who would be?
The Leader of the House.
We have the Deputy Leader of the House. If we had the Leader of the House would he have a more compassionate view towards this?
That is not very fair.
The Deputy Leader finds himself in a precarious situation.
I want to pursue this a little further. The Minister has given us very useful information in relation to the present situation in the prescribing of both medical and non-medical contraceptives that is highly relevant to the proposals in section 2. As I understand it, the Minister said he is not in a position to make any comment or any observation on the question of over-prescription. Can I take it that the review did not reveal——
On the point about the information, I certainly will give it to the Senator.
The Minister has been doing that and I appreciate that. I did not mean statistical information, but was it a conclusion of the review, was it an observation?
We do not have the information. If I had it I would give it to the Senator.
Could I ask whether there is information on the extent to which the diaphragm is made available as a contraceptive and the extent to which this is made available through advice from GPs as well as from family planning clinics? I wanted this information on the record.
It is clear from the Minister's answer to my earlier question in relation to spermicides that the spermicidal cream, foam and jelly are basically aids to be used with a diaphragm or to be used on their own in the case of the foam. They are intended to broaden the range of non-medical contraceptives for women. This is an important part of the scope of this Bill because it enables us to make some determination of whether we are satisfied that, for example, the diaphgram is sufficiently a choice in methods of contraception for women at present. It is an increasingly popular option for women, particularly in other countries, who have the full range of advice and who are in a position to come to a judgment that they do not wish to use a contraceptive pill and that they positively opt for this type of contraceptive. I do not think that option is open to sufficient women in our society and I do not think sufficient attention is being paid to this. I would welcome any clarification the Minister can give on this.
The fact that Senator Robinson has to ask these questions and the fact that we do not have information on them confirms that our collective attitude in this whole area of contraception is still very much as far away as possible from ourselves and something that should not be discussed in polite company. Considering the implication for women's health of the sort of questions that Senator Robinson has raised — I am not making this as a criticism of the Minister — one would have thought that these sorts of questions would have been addressed independently of any amendments to the legislation to deal with contraception.
One would hope that, in the light of the question that Senator Robinson has raised of the inadequacy of the statistics that are available, these questions will be addressed because they are very serious questions about the health of a large number of women. One of the regrettable aspects of a large part of this debate is that it has been to a great extent conducted by men about something which affects women far more than it does men. I suspect that a lot of our thinking about the centrality of this issue in people's lives is dominated by the fact that most of us are men and are not as directly affected by the issue as women are.
The information I can give Senators is that there was a licence as a result of the 1979 Act to import 264,000 diaphragms. In fact, the number imported was 12,500. I would go along with the expression of opinion by Senator Ryan, when he said that it is generally men who are talking about this rather than women except for Senator Robinson. Apparently that is not the point. It is more so the way people generally talk about these things. It would possibly be an education for the public in general, if it was an open discussion and was not pushed under the carpet in the typical way Irish society has operated at least in the past and possibly will continue to a certain degree in the future.
I very much agree with and echo the Minister's sentiments in this regard. I am grateful to him and I appreciate the extent to which he is providing us with whatever information he has at his disposal. In that regard could I just ask if a licence was given for an estimated figure — I appreciate that it had to be an estimate — of 264,000 diaphragms, which presumably would have been based on some sort of reasonable prediction of likely demand. It seems the actual demand is very significantly smaller. The actual demand the Minister has referred to is 12,500. That may bear out the point I was making that although at a theoretical level it would be expected that there would be that level of demand in reality the demand is very small, when you think that there are 40,000 to 50,000 women regularly on the pill from the figures the Minister gave earlier. Again that is probably an under-estimate.
That is the GMS.
Yes that is the number who are getting them on the GMS. When that is compared with total usage of 12,000 diaphragms, that is a very small percentage. I would consider this to be something that really merits serious attention. It seem to bear out that there is not an adequate effort being made. It is largely a question of ensuring that a woman who comes for advice in this area gets a very supportive range of help and advice and also that her confidence is built up and that knowldege of her physical cycle is something that she is very well aware of.
This comes back to the comment the Minister made about the general practitioners, the fact that the review showed an inadequacy, an incompleteness — the Minister himself admits in some cases a total refusal — to provide any services in the area of family planning. I would like some further comment from the Minister. It may be that there is no relation between the projected licence for a set quantity and the very small number of diaphragms. Also, could the Minister specify over what period he is talking about? Is he talking about on open-ended period or a period of years or was that licence for a set period of time?
Before the Minister replies I would like to add a little to what Senator Robinson has said. I think this is a very important question for women because while at one time the pill seemed to be the answer to everything, as the years developed it has become increasingly clear that it is very risky for quite a large number of women to use the pill as a regular form of contraception. When we say that 40,000 to 50,000 women on the GMS are using the pill that is only a certain percentage of the population. If that figure is built up into the population it may well mean that 100,000 women are using it quite regularly and then one is left with a very small number of people using the diaphragm which is probably a safer form of contraception.
I know the Minister said that education was a matter for the Minister for Education, but I feel sure that the Minister for Health can prevail upon the Minister for Education, who would have a very open mind on these subjects, to do something about it. The provision and fitting of diaphragms for women is a reasonably skilled matter. The fewness of them may possibly be as a result of lack of training in doctors. In the family planning clinics they are trained to do it but only a small proportion of the population are availing of this.
I agree with other Senators that this is far better done in the intimacy of one's relationship with one's family doctor. If family doctors are not educated to provide this particular service in their ordinary medical education they will certainly need retraining to do so. Any doctor can sit down and write a prescription for the pill. All he has to do is read up a little medical literature about it. He would need specific training in the fitting of a diaphragm. It would be important for the Minister to prevail on the Minister for Education or try the best he can through health boards' personnel to provide this training on a wider basis so that women of an older age group or with particular blood conditions should not be put at risk by taking the pill when they really should not medically do so.
There is no doubt that the number of diaphragms for which a licence was granted and the number imported is very small. If one were to compare it to the estimated number of condoms that have been used over the same period it is smaller still. I am of the opinion that females, in particular, should be fully educated in the use of all contraceptive devices for their protection and, possibly, a variety of other reasons as well. A suggestion was made recently by the Minister for Education in relation to sex education in the schools. I did not read the article but it appears from the headlines that a certain amount of opposition was mounted straightaway. I feel education should be available to all females in relation to all types of contraceptives. I will have a word with the Minister for Education.
The measuring and fitting of diaphragms is a medical process. The education required is not so much for the women. The fact that only 12,500 diaphragms have been imported is not a comment so much on the women of Ireland but a comment on the medical training of our family practitioners in this process of measuring and fitting diaphragms. If somebody has the wrong size of diaphragm then it will not be effective and it is therefore seen as a mechanism which is not effective. The education we speak of is not a matter for women but for medical students, or for post-graduate courses for family practitioners. They would then have the training and the expertise so that this option could be one that is on offer to women if it is aesthetically, medically and socially the most desirable method for them.
I asked specific questions relating to standards which apply to condoms and spermicides. Would the Minister answer those questions, please?
We have no regulations in relation to standards if the Senator is talking about condoms.
Does the BS standard not apply? I am sure this is an area where the failure rate which the Minister for Health quoted would be a cause for concern. It seems to me that 9.6 per cent is a fairly high failure rate. There are many people who believe that the actual failure rate is much higher. I take it that no standard applies at present.
No standard applies at present.
Would it be correct to say that we are really talking about importation so presumably we are importing a product that has been subject to quality control elsewhere?
It would appear like that.
If you import products like that, they could be rejects. There is no guarantee that——
I hope the Senator is not saying they have already been used.
Properly speaking, they would have to be in accordance with the standards. They would have to have a certificate. It is most important in this area of non-medical contraceptives that standards would apply but there is no Irish standard. There is no BS standard for spermicides either.
I do not know whether the contraceptives being imported are rejects. When the Senator mentioned the word rejects it reminded me of one thing. When I have some time to spare I play golf. For the standard golf ball you pay about twice the amount you pay for the reject ball.
There would not be as much risk playing with a golf ball that would not be up to the standard. When using condoms or spermicides the risk would be quite great. Regarding age qualification, the Minister stated that under the Bill it would be an offence to sell non-medical contraceptives to people under 18 years. There are serious penalties for that offence. My problem would be to determine how somebody would know that a person is over 18 years. There must be a considerable risk in deciding to sell contraceptives to somebody who may not be over the age. From that point of view a chemist would be reluctant to sell contraceptives. Under section 11 of the Principal Act where, for conscientious reasons they might opt out, there is the danger that the outlets may be restrictive.
It is quite possible we might arrive at a situation that Senator McMahon referred to earlier, that there would be an abuse of the legislation. He said this Bill is in response to an abuse of the present legislation. He made a valid point. If this does not work properly and if children of 14 or 16 are able to purchase contraceptives on a large scale, will the law be amended to cater for those people? One does not need a great imagination to foresee a time when these will be available in slot machines.
They are.
When you apply the criterion that has been applied by Members who are in favour of this Bill, that people who are brought up to understand their responsibility in life and to sexual matters, would it make any difference if they are available? They can make that choice. Are we in a situation where, on the one hand, the risks and the clause for a conscientious objection will force people to opt out or, on the other hand, due to abuse of the system, this law will be further amended to cater for people who are much younger and there will be no age qualification whatsoever?
Senator Fitzsimons has a very valid point. We can see the abuse in every town and village in Ireland of the liquor laws where we have the same age limit. It has been proven across the world that there is no way you can legislate for an age bracket unless you bring in the identity card system. The only way you will control the sale of anything to anybody is by having an identity card system. This applies in Canada and Germany. What are the Minister's views on this? One has to look at the situation where the boy could be 18, the girl could be 15, which is only second year in secondary school. There is no way that you will be able to control it. Even worse still, it could be two 15 year olds. The identity card system is the only way in which you will be able to control an age limit on anything.
I have listened to both Senators. Senator Fitzsimons says that the law at present is in total disrepute. That is the reason this Bill is before us. It is because contraceptives are available in Trinity College, UCD and grocery stores that this Bill is before us. It is for that reason that the Minister saw fit to have an age limit of 18 years imposed, to have contraceptives distributed from reputable chemist shops, reputable doctors, reputable family planning clinics and reputable health boards. I cannot see any reason for saying that these people are bringing the law into disrepute. What is happening at present is that the law is in disrepute. When Senator Fitzsimons talks about people of 14 years of age availing of contraceptives, that is a load of rubbish. When Senator Cassidy talks about ID cards you would think we were in Russia. This is a free state; it is not a Russian state. To suggest that young people should have to carry ID cards is a load of rubbish and to have to listen to this kind of crap at this time of night is absolutely intolerable.
I do not think the Senator is following the point I was trying to make. Senator McMahon made the point that this legislation has emerged through abuse of the existing law. What I am asking is that if this legislation is also abused and contraceptives become available to people under 18, will this legislation also be amended on the same basis? Senator McMahon asked was it not a very wrong basis.
I just want to ask a question. There is no amendment to the Bill and nobody has suggested an amendment. What are we talking about? It is now a straight vote as to whether you want the Bill or not. I cannot follow this. There is no amendment down to the Bill. We are talking as if the Bill were being amended when in fact the question is, are you for or against the Bill? On the basis of what has gone on all day it is a nonsense now to carry on further and it is about time the question was put.
I just want to make a short reference to the childish outburst of Senator Conway. Senator Conway may not be used to being up at this hour of the morning as I am. I am a professional and would classify myself as an expert in dealing with young people, unlike Senator Conway. I totally resent those remarks he made because anything I said was said from experience. In his field I would accept him to be the expert, but in this field we are dealing with youth and where youth congregate to be entertained and in that respect I have enormous experience and would fully understand the problems and the situation that we are discussing here tonight. For that reason I totally disagree with Senator Conway coming in at this hour of the morning and making those remarks.
Does Senator Cassidy really believe that the young people of this country from 14 years of age and upwards should go about carrying ID cards?
I was making the point in regard to the age limit of 18 years, that perhaps an ID card system was the only way that we could enforce that. We see only too frequently in this country young people being served liquor where there is also an age limit and it was in that context that I was making this suggestion. What is wrong with the 100 per cent foolproof sustem they have in Canada? That is the only way you can do it because it is very unfair——
On section 2 of the Bill, you only ask one person questions and it is not Senator Conway.
I would put it to the Minister that there is only one way you can have a foolproof system and that is to have an ID card system. There is no other way it can be done. The Liquor Act is being abused at the moment and you are actually asking the people who hold the liquor licences to identify these people as 18-year-olds, as 21-year-olds or as 16-year olds. What I am saying is a fact, and when you are speaking about facts you cannot get away from facts.
In reply to the questions raised by Senator Cassidy and Senator Fitzsimons, it is illegal to sell contraceptives to people under 18 years of age. That is made quite clear in the Bill and the responsibility rests on the heads of those who sell contraceptives to people under the age of 18 years, if they do so.
We accept that, but on paper that may seem to be correct, but in practice it is practically impossible to enforce it and it is unfair and unrealistic to think that anyone of average intelligence will expect it to be enforced even 50 per cent of the time.
If I could get back to the details of the section we are discussing, I want to move on to the next point of access. We have talked about the GPs and the present situation. Under section (2) (1) paragraph (III), the Bill provides that a person who is an employee of the health board acting as such can also sell non-medical contraceptives if the sale is made at the health institution. In other words, it ensures that health boards can sell and make available non-medical contraceptives in this way to persons of 18 or over without any authorisation. I would ask the Minister for some information on how this fits in with the extent of the existing role of health boards in providing family planning services. This is, of course, authorised by section 3 (1) of the 1979 Act which says that the Minister may by regulations provide for the purposes of making available by health boards in accordance with the regulations a family planning service. Up to this that would have been a service of an advisory nature, and what I want to know is if tied into that service of an advisory nature in the way the family planning services are defined in the 1979 Act, you now have the capacity to sell non-medical contraceptives? Is it intended to provide a comprehensive service, to fit diaphragms, to generally ensure that in each of the health board areas the health boards are actively providing this service. Perhaps in that context the Minister could refer back to what we were talking about earlier, the way in which there may have been some abuse or misinterpretation of the conscience clause under section 11.
The health boards will be providing a service similar to that which the Senator described in a full and comprehensive way.
As you were contemplating it, to what extent——
We would hope that they would operate it. It is like a question that was raised earlier on as to what can the Minister do if a person uses the conscience clause. All we can do is provide the legislation and as a result of seeing it in operation, have a look at it at some stage later on and see if it is operating to the extent and degree anticipated by the Minister.
I am very pleased to hear the Minister say that, because I think if the health boards are actively and in a very conscious way providing full comprehensive family planning services and providing contraceptives in their health board areas, then this will help substantially to fill some of the gaps in the present provision of services. That brings me on to the next category of outlet, the fact that those operating a family planning service in accordance with section 3 (3) of the 1979 Act will be able to sell non-medical contraceptives to persons of 18 or over. If the Minister has this information from the review which was carried out perhaps he could tell the House the existing family planning clinics which would qualify under section 3 (3) and, if he has them, the numbers of women who have been attending individual clinics. The numbers are not all that great and if those figures are available I would appreciate if the Minister would give them to us.
We are back again to my main worry all through this Bill and that is the doctors——have they gone out of the scene altogether or have they any role to play when this legislation goes through? We are talking about health board doctors and health board personnel. Are the doctors who are indirectly employees of the Department of Health in total agreement with it? Earlier on this evening it was almost suggested by somebody that Fianna Fáil would go back to base and they would see that their representatives on the health boards would ensure that this legislation was not implemented.
The more the debate has gone on, the more unclear it has become. I do not know whether this Bill can be made to work at all. Now we have arrived at the doctors on the health boards. Already the Minister has stated that there is a percentage of doctors who will not participate in this legislation. What happens if we have doctors on health boards who will not participate in administering this legislation?
Is that in subparagraph (i)——
I am still on section 2.
I thought we had got general agreement on subparagraph (i).
No, we have not got general agreement on that.
You got my agreement.
We got some agreement.
And the Minister is concerned that individuals like that do have a conscientious right to object if they want to. As a corporate body the Minister has the power under the 1979 Act to direct the boards to provide a service but individuals can opt out of giving the service. That has been clarified long ago.
We have the ludicrous situation at the moment where doctors can opt out of this system if they wish, but the position is that you have so many outlets that you have free availability to a much greater extent than you had before. There is no question in regard to a doctor in a health board that, if he or she refused in conscience to participate, the Minister would direct that that service would be available at the health boards. That is why this Bill is before us.
The Minister already stated that there would be no additional moneys made available for the service we are trying to provide under this legislation, and in view of that I think that the priority that will be given to this family planning service will be very low. We know that the provision of a service like this, if it is going to be an adequate service and if it is going to cater for the needs of all the people in the different areas, if the service is going to be made available at all the outlets that are named under this section, then it is important that money would be provided for the implementation of this service. The Minister of State should go back to his Department or to his Minister and ensure that sufficient money would be provided so that this service could be launched and that it not be given the low priority that I think it will be given in view of the severe cutbacks that have already taken place in the health services.
We all know that the allocations to health boards in the different areas have been cut back and that money is not being provided for very essential services. Here we are tonight introducing legislation that is going to provide a family planning service for the whole nation and we have no money to put that service into operation. We should have the money and the Minister should be prepared to back up this legislation with money to provide an adequate service for all the people.
I appreciate the concern shown by Senator Hussey in relation to the financing of this operation. What is involved is rather minimal anyway and we hope that it will be a self-financing operation. But it does certainly show a change of attitude on the Senator's part and on the part of a number of other people on that side of the House who have expressed an opinion similar to the one he has expresed now.
In regard to the question raised by Senator Honan, I have already dealt with that. It has been answered at least twice.
Senator Robinson sought a certain amount of information in relation to family planning clinics. Permission to provide family planning services has been issued at some point to a total of 11 organisations or individuals in respect of 14 locations, nine of which were in the greater Dublin area. Such clinics as were able to supply information on activities showed that 27 per cent of those who attend are new patients of the Irish Family Planning Association in Dublin; 53 per cent are seen in the Irish Family Planning Association Clinic in Dublin; 44 per cent use oral contraceptives; 3 per cent use natural methods; 42 per cent use other methods and 40 per cent in Galway and Bray were from outside the county and 15 to 20 per cent were from the Dublin clinics.
Again, this profile of the situation is helpful and it is probably late to have more comprehensive information, but we can reflect on some of the implications of the brief survey and information that the Minister has given us. In particular if we take the Galway clinic 40 per cent of the people attending, on the figures given by the Minister, are from outside.
And from Bray.
And Bray is another example. This is a very clear response to what the Minister said earlier, that there is a total inadequacy of outlets and of access. What I do not think is appreciated is the personal emotional trauma it may cause to a woman to have to go outside her area whether from Mayo, Sligo, Donegal or wherever, and travel to Galway, not telling anybody where she is going, probably not wanting anybody to see her going, probably hiding around the corner to see if she knows anybody who might see her going in the door.
This is Ireland today and Ireland probably over the next while until we sort ourselves out. If we have concern for anyone in the context of this Bill it is for any woman in that situation — she must be our prime concern. We all know that this is the situation. I suppose those of us who are women may feel it more directly but we know that married women in Ireland go in fear and in shame and guilt and go great distances to get advice. Of course at the other end of the spectrum they go in equal fear, shame and guilt for the termination of pregnancies and they go in increasing numbers to Britain. That is the other sad end of the spectrum.
When we talk about the question of cost, I would invest a lot of money in this end for the provision of comprehensive family planning services. I would regard it as the most sane preventive medicine, as the best dispersal of funds that I could think of. If we could fill those gaps that the Minister has made clear in his replies to questions, if we could ensure that there was reasonable and supportive access for women to methods of family planning and if we could broaden the range of those methods, we would have done a very good day's work for the whole health and balance of our broader medical services. It would be an enormous improvement on the existing situation.
The figures given by the Minister, the fact that, of the 11 organisations who have applied for and been granted licences for 14 locations, nine are in the greater Dublin area, that still shows an imbalance between those who have access already and the real need. It would be fair to say that there is greater access in the greater Dublin area but there probably is not enough in comparison to access in the certain other areas, either urban or rural areas, to any form of advice. The only recourse that a woman can have is to travel to a clinic, to travel to the Galway clinic or indeed to travel from the country to Dublin or to use the family planning postal service as a means of acquiring non-medical contraceptives. We have to be aware, not only of probably the inadequacy of the situation but also the personal trauma, the humiliation and the anxiety caused by this situation.
In opening up further outlets in this Bill, limited and all as it is as a proposal, one would hope that that would be complemented by a genuine concern, such as the Minister has expressed in his contributions to the debate on Committee Stage, a genuine concern to ensure that the health boards and the medical services generally provide, that GPs provide and are encouraged to provide and are educated to provide, a fully comprehensive and accessible family planning service.
I would like to develop the point raised and ask a question in relation to the point raised by Senator Honan, the place of the medical profession. It also relates to what Senator Mary Robinson has just been talking about, the need for an adequate service. That adequate service surely requires adequate counselling. We have heard about how timorous many of these women are when they reach their destination. They just do not want to receive a contraceptive; they also wish to receive some advice and counselling. Presumably in the original Act there is adequate provision for counselling but to what extent are the medical schools going to be encouraged in the future, or does he envisage encouraging the medical schools to play a more active part in the education of the profession so that, when they graduate and go out into the community, those who do not have conscientious objections will be in a much better position to provide the counselling service which is obviously so woefully lacking at present?
For your information there is diploma in family planning. It is part of the vocational training for general practitioners.
Is section 2 agreed?
It is not agreed.
The question is: "That section 2 stand part of the Bill".
Before you put that question we would not in any way like to delay, or perhaps counteract some progress that has been made but Senator Robb and I have been talking about a proposal as an amendment to this section concerning the much-debated question of chemists. We are in the process of putting together a form of words. I would like to know what is the process by which we can lodge it? Is there a way by which we can put in an amendment for section 2 concerning this unconstitutional Part I spoke about?
On Report Stage, the next Stage of the Bill.
Could I suggest that we take a recess for ten minutes in order to allow people to reflect outside on this matter, if that does not break the rules of the House? In fairness to the Minister and Senator Robinson, who has been present all evening, and to those rendering services to the Minister, I make this proposal. It would enable Senator Robb and myself to get our wording in order.
It is a matter for the Leader of the House. If we complete Committee Stage, we will talk about it then.
At what stage can I submit that amendment?
If you want to adjourn for a limited time, I am sure the Leader of the House will consider it.
How can I put an amendment to the section if it is completed?
We will take the amendment on the next Stage.
Then my amendment cannot be discussed.
I am saying it can be discussed.
You will allow a broad discussion on it?
I will not allow a broad discussion; I will allow a discussion on the amendment, if it is in order; but the amendment may not be in order. I cannot give the Senator a blank cheque now.
I am not looking for a blank cheque; I am looking for assistance. I do not want to be put in a position where my amendment, if the phraseology is not absolutely correct, will be ruled out. I want to be given an opportunity to rethink.
But you cannot put down an amendment to the section at this Stage. It is completely out of order. The only way you can put down an amendment is for Report Stage. I am prepared to ask the Leader of the House to adjourn for ten minutes to give you time to put down the amendment, provided we get Committee Stage completed.
Then I cannot, as a matter of principle, agree to the section.
That is fair enough. If you disagree with the section there is machinery to deal with that.
Question put.
The Committee divided: Tá, 35; Níl, 16.
Tá
- Belton, Luke.
- Browne, John.
- Bulbulia, Katharine.
- Burke, Ulick.
- Connor, John.
- Conway, Timmy.
- Cregan, Denis (Dino).
- Daly, Jack.
- Deenihan, Jimmy.
- Durcan, Patrick.
- Ferris, Michael.
- FitzGerald, Alexis J.G.
- Fleming, Brian.
- Harte, John.
- Higgins, Jim.
- Higgins, Michael D.
- Hourigan, Richard V.
- Howard, Michael.
- Howlin, Brendan.
- Kelleher, Peter.
- Kennedy, Patrick.
- Lennon, Joseph.
- Loughrey, Joachim.
- McAuliffe-Ennis, Helena.
- McDonald, Charlie.
- McGonagle, Stephen.
- McGuinness, Catherine I.B.
- McMahon, Larry.
- Magner, Pat.
- O'Brien, Andy.
- O'Mahony, Flor.
- Quealy, Michael A.
- Robb, John D.A.
- Robinson, Mary.
- Ross, Shane P.N.
Níl
- Cassidy, Donie.
- de Brún, Séamus.
- Ellis, John.
- Fitzsimons, Jack.
- Hillery, Brian.
- Honan, Tras.
- Hussey, Thomas.
- Kiely, Rory.
- Killilea, Mark.
- Lanigan, Mick.
- Lynch, Michael.
- Mullooly, Brian.
- O'Toole, Martin J.
- Ryan, Eoin.
- Ryan, William.
- Smith, Michael.
Tellers: Tá, Senators Belton and Harte; Níl, Senators W. Ryan and de Brún.
Question declared carried.
SECTION 3.
Question proposed "That section 3 stand part of the Bill."
Arising from subsection (4) I should like the Minister of State to inform us whether it is anticipated that there will be any delay before the Minister brings this Bill into operation by order or if there is any reason for delay arising out of section 2 of the Bill. This Bill is construed with all the Health Acts since 1947, and I noted this in relation to the 1979 Act as well. I would like to know whether that in any way adds to the powers the Minister was talking about initially under section 6 of the Health Act, 1970. They form part of the same code.
It is proposed to operate the Bill as soon as possible, within a reasonable time.
That is not saying much.
We would hope to have it operating sooner than the last family planning Bill.
Question put and agreed to.
Title agreed to.
Bill reported without amendment.
I suggest that the House adjourns for a short period, if the Leader of the House agrees, so that the Chair may have an opportunity to process the amendments, and have them circulated.
In line with my agreement to facilitate everybody I propose that the Seanad adjourn until 3.30 a.m.
Sitting suspended at 3.10 a.m. and resumed at 3.30 a.m.