asked the Minister for Health the family planning advice and facilities that are made available to the general public by each of the eight health boards; and the guidelines, if any, that have been given by his Department to health boards in relation to the provision of family planning services.
Ceisteanna—Questions. Oral Answers. - Family Planning.
5.
Arrangements for the provision of family planning services are similar in all eight health boards. The Health (Family Planning) Act, 1979, places an obligation on the Minister to provide a comprehensive natural family planning service. This service is provided by voluntary organisations assisted by my Department and the health boards.
Regulations made under the Act require health boards to provide a family planning service, as defined in the Act. They indicated that this may be done by means of arrangements under section 26 of the Health Act, 1970, in this instance through general practitioners.
In notifying health boards of the commencement of the Family Planning Act broad guidelines were set out. It was indicated that family planning advice was generally accepted as coming within the ambit of general medical practice. Persons seeking advice, therefore, normally would be expected to obtain such advice in the course of consultation with their general practitioner. Where medical card holders sought such advice the consultation fee would be covered by the General Medical Service.
The service to be provided directly by health boards was seen as complementary to the GP service. Boards might provide more specialised information or advice in relation to particular matters of family planning through their specialist obstetrical and gynaecological services. The boards could also support training programmes in family planning for general practitioners.
Family planning services in this context means information, instruction, advice or consultation in relation to family planning and contraception. It does not include the provision of contraceptives.
Would the Minister indicate whether any health boards are themselves directly providing a family planning service by way of a special service other than by simply referring people to medical practitioners? If no health boards are doing so, in the light of the differences within the medical profession on what is appropriate family planning advice, would the Minister not consider it desirable that a uniform family planning service would be provided through each health board?
I am not aware of any health boards providing a direct service. I have been endeavouring to provide amendments to the existing Act, which I regard as being deficient in many respects because it does not enable me to take action which I would otherwise wish to do. I am reviewing the position in the Eastern Health Board area. I am discussing the matter with the board and I hope substantially to improve that situation in the very near future.
Will the Minister acknowledge that some health boards have obstructed the provision of family planning services, that they have refused to provide them when requested to do so? What action are the Department taking in relation to that? What action have the Department taken in regard to providing a programme of training in family planning? Will the Minister indicate if any health board at any time have taken responsibility to provide such a training programme?
The general thrust of the Act is not aimed at placing particular responsibility on health boards to the extent the Deputy or I might wish. Health boards have not been so involved and I am reviewing the existing legislation with a view to remedying that situation so that health boards would play a more active part in providing family planning services.
Would the Minister tell us when the proposed amendments to the existing family planning legislation will be introduced and if in the course of his discussions with the Eastern Health Board he has requested them to reverse their decision to ban IUDs, a decision taken in 1980 by the Eastern Health Board? Can he indicate how many doctors in the Eastern Health Board area have theoretical and practical training in family planning generally?
There has been a very considerable change, even in the past four or five years. I came into possession of a very recent study, as yet unpublished, which states that 86 per cent of family doctors now give advice on family planning. Precise details of this are not available. I assure the Deputy I will be doing my utmost in relation to bringing forward amendments to existing legislation — I hope there will be across-the-board agreement on such amendments — and I will be giving every encouragement to health boards to become involved more actively in assisting family planning services in their areas. I should like to see in all health board areas women's clinics being set up not only for family planning but for the processing of cervical smears in relation to breast cancer. I should like to see these set up and opened on a weekly basis——
The Minister is broadening the question. We are now dealing with another crop of questions which have nothing to do with family planning.
Would the Minister confirm that his amendments, or a new Bill, have gone before the Government? Are the amendments, or the Bill, to provide for the abolition of the requirement for prescriptions for non-medical contraceptives?
We are making very slow progress. That in itself is not an evil thing but if we are now going to have a discussion on what should be in a Bill I would remind Deputies that that is for a Second Stage debate.
I have completed my review of the existing legislation and it is now about to go before the Government.
How much money has been made available this year by the Department for natural family planning advice? The Minister has announced that female sterilisation will be included in the new measure. Has he had any discussions on this matter with hospital boards? I understand that the ethics committees operating in most hospitals will not undertake female sterilisation. Therefore, it would be appropriate in advance of the legislation if he would have appropriate discussions with the hospital authorities in this regard.
In relation to the first part of the question, I have a statutory responsibility to make moneys available for research into what is known as natural family planning methods. I made a sum of £17,000 available this year for that. I do not have any legislative authority to make moneys available for other methods of contraception to other organisations — I am precluded from doing so under the Act. In regard to female sterilisation, I hold the view that it is a normal medical practice in regard to contracreption and that there should be a facility available in certain medical circumstances in hospitals, particularly in the greater Dublin area so that women would not have to go to Cork, where the waiting list is very long, or travel to either Liverpool or London to avail of established medical practice in relation to contraception. Unfortunately in the Dublin area that matter is not being resolved, but I will endeavour to resolve it.