Vol. 424 No. 2
Might I suggest at this stage that, unlike what happened in respect of the Thirteenth Amendment, we dispose of sections 1 and 2 so that then we are free to discuss the amendments and the Schedule to our hearts content and within the time limitation.
Aontaíodh altanna 1 agus 2.
Amendments Nos. 1 and 2 are related. It is proposed therefore to take both amendments together. Agreed? Agreed.
Tairgim leasú a 1:
I gCuid I, leathanach 7, líne 3, ", comhairliú nó cúnamh" a chur isteach tar éis "faisnéis",
agus
I gcuid II, leathanach 7, líne 9, ", counselling or assistance" a chur isteach tar éis "information".
I move amendment No. 1:
In Part I, page 6, line 3, after "faisnéis" to insert ", comhairliú nó cúnamh",
and
In part II, page 6, line 9, after "information" to insert ",counselling or assistance".
My amendment seeks to insert after "information" the words "counselling or assistance" in order to seek clarity in relation to what will be lawful in the State. In relation to the whole issue of abortion there will be unanimous acceptance of the need for counselling for somebody involved in a crisis pregnancy. It should be explicitly stated that counsellers involved in that activity would have the protection of law. We have already had some discussion on the word "assistance". Deputy Owen raised it in relation to the previous Bill. I have in mind, for instance, a child who is pregnant being assisted by parents. Would they and those involved in arranging travel be above possible legal action in relation to the assistance they would afford the child in procuring an abortion? We want to ensure that no third party involved in counselling or in giving assistance would be subject to prosecution as a result.
Amendment No. 2 seeks to insert after "services" the words "drugs or preparations". In relation to the question of information, when amendment 40.3.3º was proposed in this House and when it was campaigned for outside of this House we were assured that it was not intended to change anything, that nothing would change in relation to medical practice or with regard to the current position in Ireland at that time in 1983. We were assured that the only purpose was to make sure that at no point in the future could abortion be legalised in this State without the matter being referred to the people. We know that since 1983 quite a lot has changed, that students have been hounded through the courts of this State and they had to go to the European Court in order to try to establish the right to provide information on abortion. We know that books have been removed from our library shelves as a result of complaints that they contained information relating to abortion. We know that there have been complaints about various magazines which contained information about abortion. I know that quite a number of magazines in Britain which circulate in this State censor themselves in relation to various matters that they publish. I am thinking specifically of magazines aimed at women, in some cases young women, which run articles on the health of women. I have examples where these magazines excised sections of the magazines for sale in Ireland. The fact is that Article 40.3.3º has changed quite a considerable amount of practice in this State. The Open Door counselling service was closed down as a result of actions by SPUC in court. The Guardian was stopped at our national airport and was refused distribution by Easons, the people who normally distribute it, because they feared that they would be prosecuted because it contained an advertisement for the Marie Stopes clinic. The need to establish the right to information is an important one which is probably supported broadly in this House.
I have to draw the attention of the House to the underlying hypocrisy of our position as a society. We are quite prepared to ban abortion in virtually every case where the need may arise and to specifically ban suicide as a ground for abortion, but we are prepared almost unanimously to agree that a woman will have the freedom to travel anywhere she likes to have an abortion and that she may have information, albeit in fairly restricted circumstances, on where those abortions may be had. Providing abortion in this State is regarded as impossible.
I would draw the attention of the House to a question which I put to the Minister for Health on 21 October. I asked the Minister for Health the number of women in this jurisdiction who had pregnancy terminations in Britain in the latest year for which figures were available, the services, if any, which are provided by the health boards in this country for post-termination health care or counselling where this is required, and if he would make a statement on the matter. The reply, I received is interesting. It is as follows:
In 1991, the most recent year in respect of which data are available, 4,152 women resident in the State had pregnancy terminations in Britain.
In relation to the health and welfare needs of such women a broad range of services are currently provided by each health board. In the case of medical needs, obstetric and gynaecology services are available in public general hospitals which can be availed of where necessary.
As regards psychological and counselling services, the necessary support services are provided in each health board area by multi-disciplinary teams of health professionals, including psychiatrists, psychologists, community psychiatric nurses and social workers. Additionally, valuable support services and counselling are provided by voluntary agencies which are in receipt of specific funding in that regard from my Department.
The only comment I can make on that reply is that apart from the statistical fact that there are 4,152 women resident in the State who had pregnancy terminations in Britain in 1991, the reply is a load of nonsense. I have been in touch with health board officials and there are no such services available for women. What I have been told is that if by chance a social worker comes across a woman who has had an abortion she will be referred to the Rape Crisis Centre. For the Minister for Health to try to cod us into thinking that there is already in place a range of services that will counsel women on the question of abortion, or even on alternative options, is to mislead this House in a grievous way.
I have to question the bona fides of the proposal here which is seeking to make it constitutional that information will be provided with certain legal restrictions. I do not want to get into the issue of whether or not there is a difference of opinion between the Minister for Justice and the Minister for Health on the issue of the provision of information. That is not a worthwhile avenue to go down. However, it is worthwhile to question what precisely is being proposed. Statistically, in 1991 4,152 women had abortions and everyone of them needed counselling before she stepped on a plane, weeks before she stepped on a plane, and certainly every single one of them needed counselling when she stepped off that plane again. From my information not a single one of them got counselling or help from the health services on which we spend hundreds of millions of pounds. It is left, broadly speaking, to groups who provide it on a voluntary basis. It seems that the health boards themselves use such services and refer people with such needs to those services.
That is the first point I wanted to make. There is a large question mark over the seriousness with which the Government are addressing the issue of pregnancy termination in this State. We have a serious abortion problem in this country. The official figures are certainly understated because of the numbers of women who go to Britain and do not give their correct address but use addresses of relatives and friends resident in Britain. The figure is certainly understated. We are talking about at least 5,000 women this year who will have travelled to Britain for a pregnancy termination. We have an abortion problem in Ireland and we will have to deal with it. It is not sufficient simply to say that we will tell a woman where the abortion clinic is, that we will not allow the information to be put on bill-boards, that nobody will be allowed to distribute leaflets and so on. That is an entirely restrictive approach to the question of information and counselling. It is a narrow approach. I am not suggesting for a minute that there should be widespread advertising of abortion and abortion services in this country. I am not arguing for that at all. I am simply saying that the mindset that sees the question of information solely on the basis of how it can be restricted rather than how it can be provided is starting from the wrong end of the spectrum of this problem.
The Women's Information Network which, for obvious reasons, is based at a box number — they provide abortion information and if those involved in that work were to become known to the agents of the State they could be prosecuted as things stand — have provided Deputies in this House — I am sure I am not privileged in any way to get this information — with the results of a study which they carried out involving 2,000 women who contacted them about crisis pregnancies. It is clear from the information they got from the women who contacted them that the range of reasons women have for seeking an abortion are as many as there are women who seek an abortion. One of the most striking things to emerge from this information that the network provides is the almost universal terror women face when they are in this situation and the need for counselling of a compassionate kind to be available at the time they need it and not when a person may be reached at the end of a queue perhaps two or three months after the time when an abortion may be no longer possible.
We have to address this issue not just from the legalistic point of view but from the point of view of what services the Government are actually going to provide at the end of the day, assuming unanimity in this House in relation to carrying the information provision and to judge by the opinion polls in the Irish Independent today it will be carried overwhelmingly. What services will then be provided by this State for the women who need this counselling before they get on the plane, and what services will be provided when they get off the plane? Having decided that we are going to shift this problem to Britain for the foreseeable future, the least we can do is to try to provide a caring service for women who are faced with this appalling dilemma.
Let me come to the amendment which I am seeking to move. It relates to including information on drugs and preparations as well as services. The reason I am proposing it is that it is generally understood that services refer to abortion and that, generally, is thought of as a surgical procedure. I am no expert in this area but certainly it requires hospitalisation for a period both before and after. It seems that this could certainly be regarded or classified as a service.
There is now a new drug on the market; I understand it is referred to as the R4U8 pill. This has been developed in France and is widely available there. I also understand that it is available on a limited basis in the United Kingdom at the moment but it is about to become widely available there. Quite simply, the R4U8 pill is an abortifacient. If a woman who wishes to terminate a pregnancy takes this pill up to six weeks into the pregnancy, the pregnancy will be terminated without the need for hospitalisation or surgical intervention. This will result in a major change in attitudes towards abortion and a huge drop in the statistics for abortions in France and elsewhere. I understand that this is occurring already in France. I understand also from material that I have read that the number of abortions in Europe is beginning to decline, but that is a separate argument.
The reason I am seeking to have the words "drugs and preparations" included in the amendment is that it is important, if women are to be counselled in relation to the services available, that they should equally be entitled to know that there is a pill available which would obviate the necessity to go to a hospital or clinic — in other words, there are different ways by which a termination can be carried out. It seems that the use of the R4U8 pill in the vast majority of cases would reduce dramatically the trauma for women who for whatever reason must go through the process of a pregnancy termination.
I am seeking to guarantee in my amendment that women will be entitled to receive all possible information so that they will be able to make a free choice, based on their health needs, social situation and so on. We should not get involved in the business of accusing each other of being in favour of abortion on demand, or of this, that or the other, because this House agrees that we should send our women to Britain for abortions — we may not have it here but we can send them to Britain. If we are going to allow them have the information and to travel, they should be entitled to receive all possible information about the options open to them.
It is only a matter of time before this new preparation will be widely available in Britain and I am quite certain that it will be widely used there. I am seeking to guarantee that the amendment we are passing here will guarantee that women will be entitled to receive all such information and that it will not be restricted to the question of where the nearest clinic is in Manchester or London.
In relation to this amendment there is a number of issues that we need to tease out. Having studied their speeches I believe that there are some discrepancies and differences of interpretation between the statement made by the Minister for Justice, Deputy Flynn, and the speech made by the Minister for Health, Deputy O'Connell. We are dealing with semantics here. It seems the terminology used in their speeches — words such as "directive", "non-directive", "information", "all available options"— does not gel together.
I would like the Minister to tell us where the line can be drawn between the giving of information and referral. Let me give a simple example. For instance, I could say to a person that there are many shops on Grafton Street. That amounts to information. I could say that Switzers on Grafton Street have a great line in men's coats. Does this amount to a referral and will I not be able to give this information to a person? Does this not come within the meaning of the concept of giving information?
The Minister stated in his speech on Second Stage:
Directive counselling, as I understand it, is systematic guidance and advice and involves abortion referral. Non-directive counselling on the other hand, consists of the provision of information and does not involve abortion referral.
According to the Minister for Health, non-directive counselling means "setting out all the available options in order to let the person make an informed decision for herself". Is that not what Deputy De Rossa said? For instance, when this new drug becomes available should it not be included among the available options to be made known to a woman in non-directive counselling? Therefore there are discrepancies between what the Minister, Deputy Flynn, and the Minister for Health, Deputy O'Connell, consider to be directive and non-directive counselling.
I prefer to think that Deputy O'Connell's description is more in keeping with what the people want. He went on to say in his speech to hammer the point home that the proposed legislation will not only resolve the uncertainty surrounding the 1988 Supreme Court decision about doctors being unsure of the legal position but will go further in a positive way by linking the provision of abortion information in crisis pregnancies with the provision of full non-directive counselling.
Let us take as an example a pregnant woman who goes to her doctor or an advice clinic to find out the full range of options that are available to her in relation to her unwanted pregnancy. What would the position be if, having been counselled by the doctor as regards her health and told of all the options, including adoption, carrying the child to full term and abortion, the woman decides that she wishes to avail of the option of abortion? Prior to 1983 some doctors said to women that abortion was available and gave them the name of a reputable clinic. Will a doctor now, in providing full information and non-directive counselling, have to say to a pregnant woman that she will have to go out and buy a certain magazine or publication to get the names of some clinics, be they reputable or disreputable, where she will be able to have an abortion carried out? Are we not splitting hairs too finely? I am not saying that the doctor is referring the patient to a clinic but rather giving her information. I am not saying that he will telephone the clinic on her behalf to make an appointment, because this could be construed as a referral, but rather that he is giving information.
The Minister should not say to people outside the House who do not want to see information being made available that the amendment will be so restrictive that nobody will be able to find out through the counselling system where they can go to have an abortion carried out. I would like the two Ministers to clarify what appears to be a difference of interpretation in regard to non-directive counselling.
In the Minister for Health's speech he gave a list of multi-disciplinary teams of health professionals including psychiatrists, psychologists, community psychiatric nurses and social workers. In the report of the Commission on Health Funding it is virtually impossible to find any mention of the psychological services health boards will need to implement the provisions of this amendment. It is my understanding from the Eastern Health Board, that there are no counselling psychologists, as opposed to clinical psychologists, who may be able to provide this service. Has the Minister for Health considered how this amendment will be implemented when it becomes law? If a woman walks into her local health centre and requests counselling the day after it becomes law, what will happen? Will a team of properly trained people be available to give such counselling? Will resources be made available for this counselling? We all know that there is a lack of resources in this area, particularly for the more select services required by a small percentage of our population. They are the poor relations in the health services and I do not believe the structures are in place to implement the provisions of this amendment. We can say from the roof tops that such services are available but I do not believe that will be the case.
The Minister referred to doctors and advice clinics. Will doctors provide free counselling services to medical card holders and private patients or will only private patients who can afford to pay for the service be able to avail of it? Will there be extra pressure on doctors who carry out this service? Has any research been carried out in that regard? Will a suicidal pregnant woman have to visit a doctor's surgery and wait with ten to 15 other people to see the doctor while he deals with patients who have an ingrown toe nail or some other minor complaint? When her turn comes will the doctor have to act as a counsellor? Those matters have not been dealt with in this legislation.
With regard to the advice clinics and services the Minister referred to — but did not elaborate on — will these be new services financed by the Government or existing groups, such as marriage guidance counselling services, the rape crisis centres, and so on? We should be mindful of the lengths the Rape Crisis Centre had to go in order to get the Government to recognise the importance of their role. They had to go to great lengths to highlight the fact that their services were needed and that Government support was vital if the Government were not prepared to fund a direct public service in that area. We must have answers to those questions before this legislation is passed. If particular clinics are asked to provide these services will such services be free of charge and will the costs to such clinics be recouped from the Department?
It is clear from the reply to a Priority Question put to the Minister yesterday that vast areas of our health services are grossly under-funded and put to the pin of their collar to provide even a minimal service. Many of those questions referred to orthodontic services and the fact that 15,000 people are waiting for treatment.
Our public health services will not be available to react to the terms of this amendment if it becomes law.
If the clause regarding the risk to the mother's life because of self-destruction is removed, the Government must ensure that suicidal pregnant women can get immediate and urgent counselling to prevent them committing suicide or taking the boat to England. A few weeks ago I listened to a radio programme on which a spokesperson from a group, which I think call themselves "Life Rescue", in a sort of boastful manner said that members of that group travel to England and stand outside abortion clinics. He stated that they had saved ten girls from the trauma of abortion in that way. Why were they there if counselling would have stopped those women from going to England to have an abortion? That makes a case for counselling here which might prevent women who are psychologically traumatised by an unwanted pregnancy going to England to have an abortion. In order to minimise the number of women who go to England to have abortions this service must be properly structured, properly funded and available at community level. Otherwise we are wasting our time and passing legislation that will be cosmetic and of no benefit. I do not believe that is what the Minister wants.
I should like to refer to the article I quoted from The Cork Examiner by the lecturer J. Paul McCutcheon. What will be the position following 29 October when the European Court makes this decision? Obviously, the Minister does not know what the final decision will be, but it appears that the reason the students did not win their case was based on the fact that they did not have a commercial link with an abortion clinic. What will the position be if the Minister says today that a doctor must stop short of naming certain reputable clinics in the centre of London where patients will get good care? If that doctor has a commercial link with a particular clinic, will he be allowed to promote that clinic? If that is the outcome on 29 October a doctor need only create some type of commercial link with a clinic, such as a small investment of, say, £10 or £100, and refuse what the Minister referred to as directive counselling. If the decision on 29 October allows for that commercial link, how does the Minister propose to handle it if he says that a doctor cannot refer people?
That is the quandary in European law.
I hope the Minister will satisfy me on all these issues and that there is no discrepancy between the two Ministers.
By passing all stages of the Thirteenth Amendment of the Constitution Bill, the House has put in place the principle that we as a nation will facilitate Irish women who are pregnant and wish to have an abortion, for whatever reason, travelling to a neighbouring country — which in most cases is England — for the purposes of terminating the pregnancy without restriction. That is the essence of the Bill which has been passed by the House. Obviously, such women will be subject to the rules and regulations laid down in England with regard to the termination of a pregnancy. We have agreed an English solution to an Irish problem. If we agreed that in principle, surely the logic must be to follow it by putting in place all available information, counselling and assistance in this State to help women who want to avail of such a provision. That is the purpose in part of the Government's proposal now contained in this Fourteenth Amendment to the Constitution. It seeks to set down, in principle, that because we will allow women to travel to England to have an abortion, that we should at least make available to them basic information relating to it.
It is fairly clear at this stage that the motive force behind the Government in introducing this amendment in the first instance is, in fact, rulings that are pend ing from the European Court, and which are at such an advanced stage that I have no doubt that lawyers representing the State and the Attorney General are we advised as to what those rulings will be. Therefore, we have no option but to at least provide information on services available in another State, particularly a member state of the EC.
Although we are absolutely clear on the right of women to travel — and the Minister for Justice has been unequivocal about that — when it comes to providing information, the Government are indecisive. It is impossible to get a clear indication from any Minister or, indeed, any spokesperson for the Government, as to what they legislatively intend with regard to this provision once it is in place and that is regrettable. There is provision for the making available of information, but the Minister for Justice has a view on it, the Minister for Health has another and other commentators are indicating what it will mean or, unfortunately, what it will not mean. That is why I believe the amendments put forward by the Labour Party and by ourselves in Democratic Left are worthy of consideration in order to give some teeth to this provision.
Regrettably we do not have for the purposes of debate the draft legislation that the Government promises will be available by the time the Irish people vote on 3 December. It seems remarkable that a sub-committee of Government has been agitating over this matter for over six months and could not make available basic draft legislation or outline what is intended to be included in the legislation once this amendment is agreed to. It does seem that as with everything else in this debate the Government are trying to have it both ways. They say that information will be available but then introduce restrictions that the Minister for Health heralded in the Family Planning legislation earlier in the year. These restrictions were designed to placate a very fundamental, reactionary view in the community, but had the effect at the end of the day of rendering ineffective — if not ridiculous — the particular legislation that he is trying to promote in the first place.
The Minister for Health appears to be the person who will have the greatest input into this aspect of the legislation as to the type of counselling or information that can be made available to women who want it in the tragic circumstances of crisis pregnancy. Therefore, I would ask him not to repeat the exercise that he foisted upon us in this House regarding the family planning legislation when he adopted an illogically narrow approach and virtually rendered that legislation ineffective. In allowing condoms to be widely available in retail outlets but not in vending machines where people could purchase the items themselves, the Minister has, in the light of the decision by major supermarkets and retail outlets not to stock these items, virtually rendered that legislation pointless. I hope the Minister has learned from that experience and when he draws up the final terms of the legislation in regard to information that he will not have introduced so many unrealistic restrictions as to render the legislation ineffective.
There is one matter that is absolutely clear from the European experience and that is where adequate counselling, advice and assistance exist, the number of abortions decreases. In circumstances where women can be given assistance, information, advice and assurance, they can make decisions and will, I believe, opt not to have an abortion in Ireland or, indeed, in England in whatever circumstances may prevail.
The request to amplify the term "information" to include "counselling", is made in order to help women address a crisis in the first instance, and I believe it will also have the effect that appears to be the Government's aim, to avoid abortion whenever possible.
The issue also arises in regard to practical assistance. Anyone following the debate so far, and the various attempts by the Minister for Health to explain in the media, inside and outside the Chamber the provisions of this legislation will have a problem trying to understand exactly where the duties or entitlements of the public lie. The problem that may arise for people who provide airline or boat tickets is not an unreal proposition, given the uncertainty surrounding this legislation. Information does not include the activities of people who make arrangements or provide a contact telephone number. It is difficult, as a previous speaker has said, to understand where information ends and referral begins. If I understand the Minister correctly, he does not want a referral service to be established in this State under this Article. I cannot see why he has difficulty with that, given the fact that the Government have made a decision that pregnant women in Ireland can travel to England to have an abortion in any circumstances, subject only to the restrictions they might encounter under the English regime on arrival there.
That being the position and the unanimous view of this House, what is wrong, in principle, in providing a system whereby contact on behalf of the woman who is travelling can be made in advance. It would certainly help women to find the right service, the most clinically safe service and would allow for liaison between the services in regard to pre-counselling, obtaining advice from the English clinic as to what they require and in terms of liaison with the other counselling and support services in Ireland that are needed when she comes home.
The Women's Information Network, that Deputy De Rossa has already mentioned, makes this point very clearly in the report compiled by them over the last four years of their work. I quote from the section on information in that report:
British abortion clinics have commented that the lack of information has had direct negative medical consequences for Irish women. Often Irish women travel later in their pregnancy than would have been the case if the information was readily available to them. They are ill-prepared for the operation, often fearing they will be "cut open". This makes the procedure even more traumatic for them than it already is. Ironically, the lack of information also means that some Irish women arrive in Britain too early in their pregnancy for the operation to be successful and put themselves at risk of an incomplete abortion.
There is a great need not simply to provide basic information but also to allow that information to have meaning and support in the medical sense for women who we agree can and should not be hindered in travelling to Britain to have an abortion. That must involve liaison, counselling, referral and assistance in travelling. The point about people travelling too late is borne out in the figures of the National Statistics Office in Britain, published in September of this year. They state that of the women who attended for abortion in 1991, 12 per cent of those whose pregnancy was 20 weeks or longer were non-resident — not all of them were from Ireland — whereas 1.3 per cent were resident in Britain. This is clearly related to the lack of direct contact and easy referral as well as lack of information. On health grounds the Minister, in a Government that agree in principle to allow women to travel to Britain for abortion, has a duty to provide for proper counselling for these women and to ensure that they travel to a location which is clinically safe. They should be given all the information necessary. The Government cannot have it both ways. Since we are sticking to the English solution of our problem, there is a duty on us to do the second best honourable thing and ensure that women are helped in this crisis.
I hope that two other things will emerge as a result of agreeing to this amendment. First, a stop should be put to the pursuit of students through the courts who blaze the trail on information rights. I appeal to SPUC and other reactionary elements in our community who try to censure and deny information to women to stop persecuting people who simply want to disseminate basic information to women in crisis. An end should be put to these legal actions. I hope that the Minister for Health and the Minister for Justice will join with me in congratulating our students for blazing the trail on this issue. We are now doing what they argued for, many of them doing so with the prospect of being brought before the courts and subjected to huge legal costs arising from the actions they took.
I hope that the chief librarian of Dublin city and county will return to the bookshelves of the city basic books on women's health and education with regard to fertility, particularly Every-woman's Lifeguide by Dr. Miriam Stoppard. That book was ignominiously withdrawn from the shelves of public libraries in Dublin by the chief librarian, who issued a memo to the district libraries stating: “Please withdraw all editions of the above book [Dr. Stoppard's book] from stock and send to the Circulations Office with a worn-out Memo”. This ignominious act suggests not that women should not read the book but that it should not remain on the bookshelves because it is worn out. The public librarian was forced to go through that charade to meet the reservation of one member of the public who said there was something wrong with this book. Actions such as these must be stopped. The Minister should not heap more ridicule on us by trying to split hairs on such an issue. Information never hurts; it can only help.
I am very pleased that we are at the point of legislating to allow adult people to have information about very important and serious issues relating to health. Since 1983 various court cases have resulted in the withdrawal of information, as has been described by Deputy McCartan. My first reaction to these was bewilderment that in a civilised, sophisticated democracy the machinery of the State would deny to adult women specific information or books. For example, The Guardian was withdrawn on a certain day because it contained an advertisement relating to this matter. For women like myself who have always striven for equal rights, the right to free speech and so on, it is unacceptable to have to tolerate and be subject to those restrictions. I am very pleased that at last we are taking measures to change this despicable situation which has existed for far too long. In my quiet moments I wonder what the position would be if the X case had not arisen. Would we continue to put up with the position as it existed?
We are at a disadvantage in that we do not know what will be in the legislation — I appreciate that it can only be a draft — but from listening to the contribution of the Minister for Health and statements made by him on a television programme I am reasonably happy that the making available of information will be unrestricted. I hope that a stop will be put to the Messianic campaign by many groups — I have no doubt they were well intentioned and they believed that what they did was correct — of pursuing students and other groups and organisations through the courts to stop them from providing necessary information to people in a crisis.
I hope that the forthcoming referendum, which I have no doubt will be passed, will result in many people in pro-life groups becoming redundant and that they will be allowed to retire peacefully and happily. I hope that it will put an end to the setting of traps — most people in this House will know what I am talking about — one of which was set for me on the phone. Traps have also been set for a number of doctors in that a person impersonating a desperate pregnant woman visited or phoned the doctor saying that she was at the point of killing herself and asking for an address or information on abortion. I would not break the law but I certainly would help a person in this position. However, I hope that a stop will be put to the setting of these traps, that there will be no subterfuge involved and that proper information will be made available.
The point has been well made by Deputy Owen about the need to make available to women a range of services of professionals such as psychologists, social workers and counsellors. In this context I am not very hopeful because we all know that women looking for basic contraceptive advice and information are ill served here; we are far down the league in European countries in regard to making advice and information about contraception available. I hope, if the referendum is passed and legislation enshrined, that the Minister will follow it up with realistic information outlets which will ensure that the women about whom we are talking — the Minister of State, Deputy Harney, said that 20 or 30 women had gone to England for an abortion since we started this debate —will be helped.
Women can very easily find out whether they are pregnant; I am amazed when I see advertisements in this regard. In my day, when I wanted to know if I was pregnant, I had to go to a doctor and bring a specimen for testing. It was not as clinical and cold as it is today when one buys a pack in a chemist shop and can find out very quickly if one is pregnant. I am not sure how the test operates but the result is known in 12 hours.
It is available in 20 minutes.
Women nowadays know they are pregnant almost before they miss a period. It can be a very cold, lonely exercise discovering that you are pregnant at 17 or 18 years of age, or at 44 years of age when you do not really want another child. There should be a point of contact for women in regard to which they feel comfortable, to which they will readily go and which will give them all the information they need.
I stress the need for real information to be available. We should examine the position in Northern Ireland because it is not dissimilar to what we will have here. Of course it will be far more limited but I have a leaflet brought out by the Ulster Pregnancy Advisory Association which provides telephone numbers. It is readily available in doctors' surgeries and hospitals and it lists all the organisations, it deals with abortion and the law, how an organisation can help, what is involved in an abortion — which everybody should know well in advance — the practical situation with regard to the circumstances in which one would have an abortion, and travelling to England. It is very important to give the numbers of clinics because women will need to be directed to reputable ones which will do a proper job and not overcharge.
What will happen if a doctor has a conscientious objection in this regard? We would be very foolish to think that everybody will warmly welcome what we are doing. I have no doubt that there are very large pockets of resistance and I should like the Minister to indicate what will happen outside Dublin, Cork or Galway, in areas where a doctor will not become involved in imparting information and addresses. Does the Minister have a plan to deal with that point? Will women be referred to a central point and get information? I can see there could be great difficulty.
I welcome the debate on removing the total ban and censorship on information. I am sure that the Minister also welcomes it because no one was comfortable with the fact that Ireland had reached the stage — because of the Supreme Court's interpretation of the Eight Amendment — where magazines could not come into this country without containing blank pages and a little note to the effect that, because this was the Irish edition, it could not be the complete magazine available to other women — and indeed men — who read, say, Cosmopolitan to raise their consciousness in regard to these matters. It caused grave embarrassment and shame that a basic right to information had been removed because of the interpretation. We are doing something very positive in regard to the rights and freedoms of our people by reinstating the right to information. Other Members on this side of the House raised certain questions. I thought that we might have had to tease out “directive and non-directive counselling” referred to in the speech of the Minister for Justice who said:
Directive counselling, as I understand it, is systematic guidance and advice and involves abortion referral. Non-directive counselling, on the other hand, consists of the provision of information and does not involve abortion referral. Non-directive counselling would clearly be covered by the right to obtain or make available information which is provided for in the amendment.
Before the referendum on the Maastricht Treaty people gave non-directive counselling which included abortion. The point skilled professional counsellors made is that they would never involve themselves in directive counselling, of just referring people for abortion. They said that when they counselled women in regard to pregnancy they would make it very clear that they were not in any way influencing the person to opt for any particular choice. In an impartial way they left the options to the person, with support, but did not exert undue influence. In fairness to the counsellors, they have assured us that it would be totally unethical and unprofessional if they just advocated abortion. It would be a total negation of everything their skills and professionalism stood for.
There is no need to be confused in regard to directive counselling. I should like to feel that there would never be crude, directive counselling which would be just another abortion referral. We all welcome the fact that we will now be able to restore to women in crisis pregnancies the opportunity to consult an impartial, skilled, professional person who will give them information from which they will be able to get enough knowledge and support to stop them choosing the option of abortion. All of us would hope for that. I want to point out the need for this kind of counselling, especially in Ireland. In a paper prepared by Professor Anthony Clare and Dr. J. Tyrell, Psychiatric Indications for Abortion—Are There Any?, it was stated:
Certain groups do appear especially at risk from the adverse effects of abortion. Negative religious or cultural attitudes to abortion are associated with higher levels of post-abortion psychopathology. For example, Roman Catholics experience more guilt than Protestants and Protestants more guilt than Jews.
I am delighted to say that that statement is based on research. It is certainly not my personal observation.
I thought I was hearing things.
I shall continue that quotation:
Membership of a cultural group which is antagonistic towards abortion and sexuality is also identified as loading for poor outcome in a number of studies. Such findings are highly relevant to the Irish situation.
Another statement made in that paper reads:
Given the circumstances that surround the abortions undergone by Irish women — the fact that they have to be surreptitious, have to be performed in a foreign land and are regularly categorised as murder by religious and political critics — it is highly likely that many Irish women do experience profound, persistent and disabling psychiatric symptomatology following the terminations of their pregnancies in the UK. The implications in terms of the provision of appropriate pregnancy counselling and support... would point to a particular need for Irish women.
I quote those statements to demonstrate that there is a real need certainly for counselling before a women chooses what option she will take in a crisis pregnancy and also, because of the special circumstances in Ireland, for counselling after an abortion for women who would feel the guilt and the isolation to which they are subject as a result of the situation in Ireland up to now. One of the fervent hopes that all of us would have is that resulting from counselling there would be a lower rate of abortion, much greater support and removal of the very grave and persistent feelings of guilt, isolation and secrecy experienced by Irish women at present.
What recognition and funding will be given immediately to clinics already skilled and experienced in carrying out the kind of counselling we are talking about? So far as I know, at the moment those clinics get no State funding. They rely on contributions, which has an impact on the provision of counselling for poorer women and women who cannot afford high consultation fees.
I should like the Minister for Health to tell the House the way in which we are going to provide regional counselling as quickly and as effectively as possible. I know that there are several professional and well served clinics in Dublin that have a long experience and a code of ethics in this counselling, but we have to be concerned about women in rural areas. For rural women caught in crisis pregnancies not only time but also accessibility would be terribly important. We must ensure that regional advice and counselling are available so that women do not have to travel long distances or draw attention to themselves by having to take a whole day off work, for example, at a time when they may prefer to take advantge of that advice and counselling without the knowledge of the community and perhaps even the family.
The concept of a total, supportive, psychological counselling service has to be taken into consideration. We will need skilled people in that area. The medical profession, who may feel that they have neither the skills nor the time to enter into this kind of counselling, should be able to refer easily and quickly women who would need that counselling immediately.
Minister Flynn said that he would like the thrust of the measure we are introducing to be affirmative for women, not negative. I make a plea that the information and counselling also be affirmative rather than negative.
(Carlow-Kilkenny): I know well that the public have available to them in this country hip operations and dental treatment if they live long enough to reach the top of a waiting list. I hope that we are not going to have another fairytale from Hans Christian Flynn of Hans Christian O'Connell about advice centres——
That is not my name.
Deputy Browne might be inclined at times to a sense of humour, which we all enjoy, but perhaps on reflection he might feel happier were he to give to everybody here present his or her official title, as is required by the Standing Orders.
That is one of the happy things about the House. I cannot control what people call me outside the House but I can do so inside the House.
(Carlow-Kilkenny): Hans Christian Anderson was a famous man.
I would go along with that.
(Carlow-Kilkenny): If I have been out of order, I withdraw the title I gave the Minister.
No offence was taken.
(Carlow-Kilkenny): We should be realistic about this matter. If we are not going to have places where pregnant women can go to get advice and information we are only putting a dalla mhullóg on everybody — we are just bluffing. I feel that the crunch will come when everything is over and the measure has been introduced.
My colleague has raised a point that I wanted to bring to the attention of the House: I hope that the Government will not consider that they can fulfil their obligation by providing a centre in Dublin and expecting everybody to fall into line. If a woman sets out with the idea of having an abortion she will not want to go for advice to a church advice centre because she will feel — perhaps wrongly — that she will not be treated properly. If the same woman could go to another advice centre she might very easily, having heard the options, change her mind — as we have been told. It is important that centres be provided throughout the country and it is important that the Government do not fall back on the churches, who are doing marvellous work in their own way, because that would be a cop-out for the Government. I would hate to think that once the legislation has been passed we will, because of other financial commitments, finish up with the same lack of services as experienced in other areas of health.
I have a few words to say but I think that perhaps Members would prefer to hear from the Minister for Health on some of these issues. However, the Minister and I are ad unum in what we wish to happen in this regard.
I thank those who have made initial contributions to the debate. I note that Deputy Howlin is back in the House——
Very briefly.
The Deputy initially raised a question about the chance of people being prosecuted if they were assisting in any way. Certainly that is not contemplated. That aspect was dealt with effectively in relation to the proposed Thirteenth Amendment to the Constitution. The same applies in this instance, and I am of the opinion that Deputy Howlin would wish it to be that way.
Deputy De Rossa spoke at some length about the needs of pregnant women and particularly their need for counselling services. I was pleased to hear him say he is opposed to widespread advertising of abortion services, a point that has been re-echoed by many speakers. Many of the contributions, which centred around what will happen after the Amendment has been passed, were supportive. It is still only a Bill and the people have to decide on this matter. We are taking it for granted that they will give us an affirmative in this matter and that is something we hope for in all three referenda. In so far as this particular one is concerned there appears to be a great desire in the House that it would be recommended to the people in general that they give us an endorsement of this Amendment. No objection has been raised in regard to the thrust of this Amendment. I am pleased to acknowledge that from the Deputies who have contributed.
We cannot — and this has been recognised by the Deputies who contributed — have the legislation published for the obvious reason that one has to await the decision of the people. They have to decide that this is the way they wish to proceed and that this is what they want the Constitution to allow. It was in that manner we discussed it at the sub-committee and it was decided to recommend that a summary of the draft proposals would be made known, and that may be helpful. My colleague, the Minister for Health, Deputy O'Connell, has been helpful in that regard. I was particularly pleased to hear Deputy Fennell say she supports that in a broad way. In fact, everybody has agreed that it is the right thing to do but what we are really talking about is the kind of contribution they may well make on Second Stage or some other Stage when the proposals are actually published.
We will not get a chance.
I was interested to note that the Leas-Cheann Comhairle was willing to let it run on because it does give those of us who will have an input subsequently when the actual heads are being agreed that we would know——
On a point of order, is the Minister telling us that between now and 3 December there will be draft legislation?
No, I am merely saying it depends on what the people decide. That point was recognised by Deputy Fennell in particular.
We cannot even discuss the draft legislation.
That is the point. I am talking about the summary of what we would consider appropriate to put into those heads even though it is somewhat in advance of the agreement of the people to accept the amendment. That point must be borne in mind. It is a rather critical point and we would be very hopeful that Deputies would apply their minds to supporting the Amendment in a positive way outside so that an alternative view does not gain a grip that would not wish it to be endorsed by the people.
We have heard much about what Deputies would wish to see happen following the publication and agreement by the House of legislation, following endorsement of the amendment and I know we will hear much more as time goes on. We were speaking about amendments Nos. 1 and 2 which are being taken together. I am opposed to amendment No. 1. It is slightly different from what we discussed for the past hour in so far as we dealt with services that may be provided — and hopefully will be provided — following the successful endorsement of the amendment and followed by the publication and agreement of the necessary legislation in so far as the House deems it necessary.
This amendment to the Schedule of the Fourteenth Amendment to the Constitution Bill is being opposed. Both the Minister for Health, Deputy O'Connell, and myself made it very clear in our contributions on Second Stage that the Bill permits non-directive counselling——
How can the Minister say that?
——but does not permit directive counselling. Directive counselling involves abortion referral. The intention of the Bill is to preclude that kind of counselling from being allowed in the jurisdiction. The Minister for Health has outlined the details of the legislation he proposes to bring forward for controls on the supply of information in the event of the Amendment to the Constitution, that is provided for in the Bill, being accepted by the people in the forthcoming referendum. I think we have all been taking that slightly for granted. I do not take anything for granted in political life but I am hopeful, from what I have heard in the House today, there will be a positive result and it will require the legislation about which we have spoken.
The Minister for Health made it clear that information will include that provided by a doctor or an advice agency to a pregnant woman who seeks the advice concerning her own specific circumstances. He also said it will be a requirement that in such circumstances information must be given in the context of non-directive counselling and the full range of alternative options available to the person concerned. That is the important issue to which Deputy Barnes referred. Let us be clear that there is no difference of opinion. The Minister for Health said non-directive counselling means setting out all the available options in order to let the person make an informed decision. It is important that a complete range of options be made available to them so that they know precisely what they were getting into. They would then be in a position to make an educated and informed decision. Freedom to obtain information regarding services lawfully in another state, which the Government's wording protects, clearly allows non-directive counselling.
Why does it disallow directive counselling?
My colleague pointed out that following the 1988 Supreme Court decision concerning information, doctors had been unsure of their legal position regarding counselling in a crisis pregnancy. In order to get around that difficulty and to put it in a way that everybody understands precisely what is proper in accordance with the law this legislation will be published in due course.
The view of the Minister for Health, Deputy O'Connell, is that the proposed legislation will not only resolve the uncertainty but will link the provision of abortion information in crisis pregnancies with the provision of full, non-directive counselling. The amendment proposed by Deputies Spring and Howlin, which seeks to insert the words "counselling and assistance" into the Bill would clearly allow directive counselling and abortion referral. The Government are of the view that a provision of that kind is unacceptable. That would not be in the public interest or in accord with the provisions of the Constitution. I would ask Deputy Owen to take it for what it is worth that there is no difference of opinion between what the Minister for Health stated in his contribution last evening and what I stated in the course of my brief reference to the matter in my earlier speech. My view, as expressed, is entirely consistent with what the Minister for Health said yesterday but I am glad to have the opportunity to clarify it further if that is necessary. From what I have heard Deputies on the opposite side say, there is no difference of opinion between us on basic fundamental matters in this regard.
The EC court's decision was raised. The effect of the EC court's decision is that while lawful abortion in a state constitutes a service within the meaning of Article 59 of the EC Treaty, it is not contrary to Community law for a member state, in which abortion is forbidden, to prohibit the distribution of information about abortion services available in another member state where there is no economic link between the abortion service and the distribution of the information provided.
The court did not make a specific decision but there was an implication that if there was such a link the distribution of the information would be permissible under community law. It is not so much a question of interpretation but of the way people understand EC law to operate in so far as commercial links are concerned. To put it in colloquial terminology, the students did not have the commercial link. Had it been formulated in a different way, they might have had by acting as agents for the commercial concern. Under EC law the provision of this service is a commercial concern. The provision of a particular service, which is available and allowable under EC legislation, is regarded as a profitable business. It is proper and necessary that information would be provided in this way. One has to have a commercial link and, as I understand it, that is the reason the matter was adjudged in the way it was.
The matter is not straightforward and it is recognised that member states have a margin of discretion within which to decide what should be permissible under national law. That is written into EC law. The EC Court has consistently held that Article 59 of the EC Treaty requires the abolition of any restriction which has the aim or effect of treating a provider of services established in a member state other than the member state where the service is provided less favourably on account of his nationality or place of establishment than a provider of services who is established in the particular member state. Article 59 is the key Article. It also requires the abolition of any restrictions which the recipient of services might encounter on account of his nationality or the fact that he is established in a member state other than that to which he goes in order to receive the services.
It follows from the case law in the EC Court of Justice that not only the providers of services, who do so by way of trade or profession, derive rights from the Treaty provisions on freedom to provide services, but also Community citizens who wish to receive services. Of course, the question arises as to whether the right of Community citizens to receive services in another member state encompasses the right to receive unimpeded information in one's own member state about the provider of services in another member state. It appears that a prohibition on the distribution to persons resident in a member state of specific information designed to promote activities which are contrary to the legitimate public policy of that state, if performed there, may be applied even where the information invites persons to make use of those activities in another member state where the likely or intended result of the provision of such information is to undermine that public policy. That is the general understanding in so far as Article 59 of the Treaty is concerned.
The Minister has not tackled the issue of the commercial link. If a doctor makes a commercial link can he give the information the students, who did not have a commercial link, were seeking to give?
It is not for me to advise how the students might have framed their action differently but I think the message can be got from what I have said — the matter might have been judged in an entirely different way if they had established a commercial link.
What the Minister is saying is that if the students had been providing this service for money they would have been allowed to disseminate any information they wanted but because they were doing it voluntarily they could not. Will it be acceptable in the changed circumstances for a doctor to make available for money the names of abortion clinics?
I am sorry to intervene again but I think it is better if we continue on——
The Minister did not fully tackle the issue.
When the Minister resumes his seat the Deputy will get an opportunity to put that specific question and any other questions regarded as relevant. I note that Deputy De Rossa has been offering. When the Minister has concluded, I will invite Deputy De Rossa.
It is important to point out that even in the Grogan case, which was dealt with in the European Court of Justice, there is no absolute right to information. The provision of information has to be subject to appropriate conditions laid down in national law. That is the point I am getting at here today. Following the endorsement of the Fourteenth Amendment by the Irish people legislation will be needed. Our freedom to set down our position in national law remains with us. We can do this in certain circumstances. This issue will be covered in the legislation to be introduced by the Minister for Health. Certainly, circumstances will change; they will change quite dramatically following the expected endorsement of the Fourteenth Amendment. So far as information was concerned things changed quite dramatically after the X case and the Supreme Court judgment. The parameters of this have not yet been outlined, and this legislation will attend to the matter. That is the important point. As I said, there is no difference of opinion between the Minister for Health and myself as to how this should be done. We are simply saying that referrals will not be permitted but all options will be made available in so far as information is concerned. It will then be a matter for individuals to make up their minds. The Minister for Health has indicated that he wishes to contribute later.
With regard to the question of commercial linkage, as I understand it the European Court of Justice made a decision that students had no automatic right under Community law to provide information unless there was a commercial link.
That is correct.
As I understand it, they did not necessarily decide that this should be the case in all circumstances. For example, if I want to provide information on the availability of tractors in Britain, there is no obligation on me to have a commercial link with a company in Britain in order to provide that information. Their decision related only to the specific case of abortion information as it related to Article 40.3.3º — they have no automatic right to provide this information without a commercial link. I wonder whether a similar decision would have been made if the case had been brought to the European Court of Human Rights. Of course, that was not done, and I do not know whether it might have been done. Will the Minister clarify — this point has not been clarified to date — if the Government's proposal on information goes through, will the necessity for a commercial link so far as the European Court is concerned still apply in relation to abortion information or will it be overcome by the current proposal? To put it another way, the proposal we are discussing does not oblige a commercial link to exist; it just says information.
That is correct.
Regardless of what we may do in this House at a later stage in relation to restricting that information, which is being proposed, will the Minister now clarify whether there will be a necessity for doctors, counsellors and voluntary agencies who provide information to have a commercial link in Britain and elsewhere in order to provide that information?
The problem with the entire debate on this proposal — this has been well illustrated by the contributions made on it — is that none of us really knows what we are talking about in the sense that we do not know what legislation the Government intend to produce. We are talking around the problem, not dealing with the substance of it. There is general agreement in this House that a woman who becomes pregnant is entitled to have made available to her information on the options that exist. We are talking about directive and non-directive counselling in a somewhat confined way. My view of what constitutes directive or non-directive counselling may differ from somebody else's view.
The Minister says that if the abortion issue is raised, counselling must be non-directive. There are many organisations on different sides of this debate and with different views about abortion who engage to some extent in counselling. Even those organisations which take the view that ultimately the woman must make the choice as to the options she follows would generally be of the view that they engage in some degree of directive counselling in the sense that they ensure women are fully aware of the alternatives to abortion. If somebody has an unwanted pregnancy, she cannot be forced to stay in Ireland and have the baby. If she gets on a plane, we have no involvement in what then happens. Some people would be of the view, perhaps rightly, that a woman can be encouraged not to have an abortion by having explained to her the relevant support and social welfare services available and so on.
I should like to see a decline in the number of Irish women having abortions in Britain. I do not have a laissez faire attitude to this. I dislike the hypocrisy of pretending we do not have a problem, simply because pregnancies are not terminated here. About 4,000 women who state they live in Ireland go to Britain every year for abortions. They are the official figures; there are probably more. The Minister might be of the view that those who are counselling have an objective role to encourage people thinking of abortion not to follow that road. I would be very surprised if the Minister for Health or the Minister for Justice were of the view that one should not at least try to encourage women thinking of abortion not to proceed. Most of us would be of the view that one should try to encourage them not to have an abortion, but the ultimate decision will be made by the woman. If I as a counsellor discuss all the options and encourage a woman not to have an abortion, that is directive counselling. Is that illegal? Do the Government envisage putting legislation in place which will make it contrary to law, having provided people with options, to encourage them not to take the option of the plane to England for an abortion? If that is what the Government are saying, it is extraordinary.
It is not what I am saying.
This is the problem in regard to directive and non-directive counselling. There is a view that somewhere outside this House there is a group of people involved in a conspiracy to send as many Irish women as possible to England to have abortions. It is total nonsense that a group of people who want to be directive are pushing people into having abortions. I do not know of any group who have that view. I know there are groups who have provided voluntary services for women faced with crisis pregnancies and who have told them that if they cannot complete their pregnancies the option is to go to Britain and have them terminated. I am unaware of any group who do that without also giving the other options available, telling women that if they can complete their pregnancy adoption is an option and indicating the support services which would allow a person to remain here and keep the child. We have supports such as the unmarried mother's allowance, but we do not have the coherent social action programme we need.
I am a member of Dublin County Council. Until the housing crisis reached its present state under this Government, we were able in 1986-87 to offer reasonable housing accommodation to unmarried mothers. They were not left at the bottom of the list, isolated in bedsitters with no social supports and paying exorbitant rents. It is no longer possible to provide for such people. Some local authorities cannot provide housing for married couples with three or four children.
We must not get hung up on the question of directive and non-directive counselling. I do not want people to be encouraged to have abortions. Neither do I want a law which is so oddly phrased that a counsellor who tries to provide encouragement not to terminate a pregnancy is out of line because such encouragement constitutes directive counselling. That is a very odd way to proceed.
The problem is that we do not know what will be in the legislation. I can parse and analyse the speeches of the Minister for Justice and the Minister for Health and suggest there is a difference between the two speeches. There did seem to be a degree of difference and confusion between the two Ministers, but that may be unfair. The difficulty is born of the fact that we do not have the legislation. We do not know the specifics of what the Minister intends to produce.
If somebody has a crisis pregnancy, information means not only explaining how to keep the child, the supports which are available and the option of adoption or abortion; it also includes giving some information to the person who opts for abortion about reputable places in Britain, as opposed to allowing that person to travel to England and go to a place which is not reputable, with the attendant risk to health.
I am greatly confused about what the Minister for Justice is saying. He has said that people engaged in counselling can go as far as presenting the options but cannot give the woman the name and address of a reputable place if she has to opt for abortion. Is that the giving of information or is it a "referral"? The Minister for Health was more comprehensive in that he seemed to say that if a person opts for abortion a counsellor can tell her where she should go. The Minister for Justice seems to say that this cannot be done because it is a sort of referral. I want to see a rapid decline in the number of Irish women having abortions in England. For those people who take those options, I would rather they were referred by responsible agencies or medical practitioners to somewhere that deals properly with women and properly engages in further counselling before a termination takes place, than that they be simply left to their own devices to pick up some glossy magazine and get an address of some clinic which might not be the right place to go at all. We need to clarify this.
The Minister for Justice has a problem. We keep talking about "referral" which is supposed to strike horror into the heart. What does "referral" mean? It may simply mean giving a name and address but it may mean something more than that. The only other meaning referral can have in the medical context as Deputy O'Connell will know is that a GP, as is usual when referring a patient to a specialist, does one or two things. He either gives the patient a letter or gives him a letter and rings the specialist out of concern for his patient, in order to make the specialist aware of a particular medical condition which may be of relevance. That is what referral normally means and there are sound reasons for it. The reason is that the GP has perhaps been caring for the person for a number of years and is aware of the general medical history and believes it is something the specialist must know in determining what type of treatment might be appropriate. The referral may contain basic information, for example with regard to allergies to particular drugs. If the doctor knows that a person reacts badly to penicillin, he will give that information as well as perhaps information on the patient's blood grouping. If someone is a haemophiliac requiring particular treatment the GP will certainly say that in a referral letter.
If a pregnant woman makes that awful choice of going to England to terminate a pregnancy, what function will referral have in addition to giving a name and address? Its only function will be so that a medical practitioner in Ireland can ensure that the doctor from whom she will seek help in England will also know the woman's medical history in so far as it is relevant. Are we saying that it will be against the law here, not under this amendment but ultimately under the legislation, for a general practitioner whose patient opts for a pregnancy temination in England, to give a letter of referral or to make a phone call of referral so as to ensure that the hospital, clinic or doctor with whom the patient consults in England is aware of the relevant medical history? That is the only thing I can see as a referral. We need to clarify that.
Will Deputy Shatter accept that his interesting indulgence now is more anticipatory than dealing with what we must attend to here.
What we are considering here is what "information" means. The Minister seems to be making a distinction between directional and non-directional counselling and information and referral. I am trying to explain that they are all the same thing.
No, they are not.
I have made the point and it is something the Minister for Health may wish to respond to.
In the context of the Grogan case, in the area of information, I am at one with something the Minister, Deputy O'Connell, said last night, and which the Fine Gael Party said, and as I pointed out in a particular way last March when we were pressing the Government to hold referenda on the travel and information issues. We said that the sort of amendment the Minister is proposing — and we support the constitutional amendment — was the type of thing that was necessary, an amendment that would allow for the giving and obtaining of information and allow the Oireachtas to legislate. I agree with the Minister for Health that we do not want great big advertisement hoardings encouraging people to have abortions. Nobody wants that. The Minister is right — this area must be legislated for.
In the context of obtaining information the Minister has explained to the House generally the current position in relation to the law as a result of SPUC v. Grogan, but what he has not been explicit about is that as a direct result of the SPUC v. Grogan case, under European law since the judgment in that case was delivered in October 1991, any commercial agency terminating pregnancies in any state in the EC has been able to advertise their services in this country. The Minister has not fully explained how the result of the SPUC v. Grogan case will interact with the constitutional amendment he is proposing, taken together with the legislation that is being talked about. There is one very express piece in the report of the SPUC v. Grogan case in the 1991 3 Common Law Reports at page 1990 where it says:
The reply to the national court's second and third questions must therefore be that it is not contrary to Community law for a member-state in which medical termination of pregnancy is forbidden to prohibit students associations from distributing information about the identity and location of clinics in another member-state where voluntary termination of pregnancy is lawfully carried out and the means of communicating with those clinics, where the clinics in question have no involvement in the distribution of the said information.
It is quite clear as a result of that case — and my colleague Deputy Owen when she interrupted the Minister raised this — that an agency that has a commercial interest can advertise here under European law and, it appears, can promote abortion services. That seems to be the direct result of the SPUC v. Grogan case and nothing we put into our Constitution can disrupt that. Our legislation can properly delimit the manner of promotion. I would like the Minister to tell the House how he sees the constitutional provision and the legislation working if the information change is approved by referendum, which I hope it is, in the light of the judgment in SPUC v. Grogan.
Deputy Shatter is teasing out where the difficulties will lie. The Minister for Justice in his speech made a statement which is clearly not factual when he said:
The amendment would not permit directive counselling but would permit non-directive counselling.
With respect, it is not the wording of the amendment that will say what way the information will be given but the legislation.
That is right.
The Minister's speech says "the amendment would not permit". It is the amendment, subject to the legislation that the Minister might bring in. I think that the wording which then goes on to describe what directive counselling is refers to abortion referral. Minister O'Connell's speech uses the word "promote".
Tugadh tuairisc ar a ndearnadh; an Coiste do shuí arís.
