Dáil Éireann díospóireacht -
Thursday, 3 Jun 1993

Vol. 431 No. 8

Health (Family Planning) (Amendment) Bill, 1993: Second Stage (Resumed).

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

Mr. Kemmy:

On behalf of the Labour Party, I welcome this Bill. This has been part of Labour policy for a long time. As chairman of the party I am very pleased to have this opportunity to say "Well done" to the Minister for bringing it before the House so quickly. This is a good day not only for democracy in this House but in the country at large.

As has been pointed out, the provisions of the Bill will ensure there is greater access to condoms in our society. As Deputy McManus pointed out, many chemist shops are squeamish about stocking condoms. That is a pity. As both Deputies McManus and O'Donnell pointed out, this measure will not stop AIDS or bring unwanted pregnancies to an end; but it should be said that it will be a positive help.

Deputy McManus was somewhat critical of the television advertising campaign but it must be remembered that this is the first attempt to make our society aware of the dangers of AIDS. In that context both the Minister for Health and his colleague, the Minister for Arts, Culture and the Gaeltacht, Deputy M. Higgins, should be congratulated. While the advertisements are not perfect and will not win an Oscar award, they make an honest and direct effort to inform our people of the scourge of AIDS. That is a good thing. Those people, the young and not so young, who took part in this advertisement deserve to be congratulated for their courage. They have faced this problem in a very direct way. I am sure the advertisements will be improved with the passage of time.

I was one of the founding officers of the Limerick Family Planning Association some 18 years ago. I invited officers from the Irish Family Planning Association to a meeting in the Royal George Hotel in Limerick and from that meeting the Limerick Family Planning Association was set up and the first family planning clinic was established in the teeth of very strong opposition, some of which came from members of Deputy O'Donnell's party. One of the strongest opponents was Deputy O'Malley. He spoke out against encouraging fornication and promiscuity.

Ms O'Donnell:

He was not on his own.

Mr. Kemmy:

That is true. He has experienced a conversion. Perhaps his wife and family have played a part in his change of heart and I am very pleased to hear him speak this morning on this issue. If he can change his mind on that fundamental point, there is hope for Irish politics. I did not think I would live to see the day when a measure such as this would come before the House and be totally supported by all parties. I did not think I would live that long. Now that realism on this issue has at last reached the floor of this House, there is hope for Irish politics. I could write a book about my experiences in the Limerick Family Planning Clinic. A canon from Kilfinnane, County Limerick, condemned me from the pulpit and in his newsletter to his parishioners. He called the women who entered the family planning clinic "Kemmy's femies", which was a very good phrase. I bear him no bitterness. We live in a democratic society and people are entitled to voice their opinion. When I look back at those times it is with sadness rather than anger that so much misinformation and well intentioned advice was misdirected. I will not labour that point.

Because I have experience of working as a volunteer in the clinic over a number of years I can echo some of the points made by Deputies O'Donnell and McManus. Both Deputies have to be complimented on the forthright way they expressed their views, because for all too long the floor was left to the men. This issue has convulsed Irish political parties in the past and caused distress to individuals and parties. I am delighted that this Bill is totally unopposed and has been warmly welcomed by all parties.

Recently I visited Lesotho, which is surrounded by South Africa, a country with many problems, including AIDS. I would hate to see the pain and suffering that has been caused by AIDS spreading to other countries. It is a cruel thing that one sexual act can cost a life. I was alarmed to read a report in a Sunday newspaper that a female prostitute has AIDS. I do not know if this has been confirmed by the medical authorities in the Eastern Health Board, but if it is true it has serious consequences for our society. I think the Minister is obliged to check on this reported case because a sexually active prostitute with AIDS is a time bomb which will go off constantly and will cause disease to spread in the country. Will the Minister have this matter looked into?

There is no point in being squemish. We have to face up to the issue. Deputies McManus and O'Donnell took a commonsense approach to the matter. The work of groups, gay groups in particular, in raising our awareness and educating people on AIDS is to be welcomed. Their pioneering work has also pushed the politician to take action in this area.

Deputy Howlin has been practical, determined and enlightened in his attitude to this matter. He has refused to bow to prejudice, pressure or superstition and has taken a good deal of pressure off the rest of us. He has adopted a commonsense attitude and I am pleased that our party has led the way. I should like to share my time with Deputy Derek McDowell.

An Leas-Cheann Comhairle:

Is that agreed? Agreed.

Mr. Kemmy:

All too often in the past society has been worked up on issues about contraception to the detriment of our people as a whole. Unemployment, emigration of young people and other social ills are far more important and should take much more of our time. In the past we had a national hang-up on this question. I am delighted today that realism has reached the floor of this House. I welcome the measure and congratulate the Minister for his work in this regard. I thank my colleagues on the other side of the House for their support of the measure.

Mr. D. McDowell:

May I share my time with Deputy Joe Costello?

An Leas-Cheann Comhairle:

Yes.

Mr. D. McDowell:

I am particularly happy to welcome this Bill today. I am especially happy that a Labour Minister is introducing the first chunk in the Government's social programme. My party was the first to come to grips with this issue some 20 or more years ago, at a time when I and some other Deputies in the House were still at school. That is an indication of how long it has taken this country and the House to come to grips with an important social issue.

In his contribution this morning the Minister dealt in some detail with the contribution which condoms can make in combating the spread of HIV and, indeed, sexually transmitted diseases generally. That is absolutely clear and the Opposition spokespersons have also cited the medical evidence to this effect. It is important that we say that because there has been a campaign by groups and individuals outside this House to sow the seeds of doubt in the public mind — groups and individuals who, in large part, are following an agenda which has nothing whatever to do with preventing the spread of disease. I am disturbed and distressed that individuals who have a religious or theological objection to the use of family planning methods or condoms generally should encroach on the area of disease prevention in order to follow their particular agenda. They are behaving dishonestly and irresponsibly and I regret it.

The Minister has dealt in great detail with the role of condoms in preventing the spread of disease. We must also acknowledge the other important contribution which condoms can make to our society in preventing unwanted pregnancies. It would be nice to think that every pregnancy and every child was wanted but, sadly, that is not the case. We are all painfully aware that there are many unwanted pregnancies. Our alarmingly high abortion figures are adequate testament to that.

We have to give the wherewithal to people, to individuals, to couples, to women, in particular, freely to exercise their consciences in taking whatever measures they wish to prevent unwanted pregnancies. Previously healthy relationships come under deep strain if an unintended pregnancy results. It is particularly traumatic for a woman who had not intended to become pregnant. It also has an impoverishing effect on many families and individuals. A pregnancy is expensive — rearing a child in the nineties is expensive. There are many individual women and families who simply cannot afford it. As a State and as a Legislature we have a duty to give those people the wherewithal to ensure, in so far as we can, that unwanted pregnancies do not occur.

Nobody in this House would advocate or defend casual or promiscuous sexual relations. We have an obligation in our school and elsewhere to engage in sex education programmes which will give people the wherewithal to make conscientious decisions. Our record in sex education in our schools is by no means unblemished. I am aware there has been considerable progress in recent years in individual schools in programmes initiated by individual teachers. In recent years the Department has come to grips with this issue but there is still much room for improvement.

The Minister for Health and his colleague, the Minister for Education, clearly have a role in this matter. We must provide inservice training of teachers. It does not come naturally to many teachers, who are not trained, to give sex education classes in schools. It is a particularly sensitive issue. It is important that teachers are given facilities, including video tapes and easy access media communications paraphernalia so that children can be given the knowledge they need to equip them for life.

If we do not defend or encourage casual sex, likewise we should not pretend it does not happen. It happens regularly. We cannot legislate for hormonal urges — we certainly cannot legislate them out of existence. We must recognise that there is a problem with casual sex and unwanted pregnancies. Essentially what this amounts to is the free exercise of conscience. If people are satisfied in their own minds to use condoms or whatever other method of contraception they wish, then they are perfectly entitled to do so. It is high time the Legislature bowed out of the bedroom and left that decision making, as it should be left, to two consenting adults.

I am happy that this section of the Government's social programme will shortly be in place. I am happy that it appears to have the support of all Members. It is a remarkable commentary that something that has tortured our political life for about 20 years, as Deputy Kemmy has so well illustrated, should go through the Dáil so quickly today. It is a commentary on the maturity of this House and our society. I am happy to suport this Bill and I commend the Minister for introducing it.

Mr. Costello:

I am grateful for the opportunity to address the House on this matter which I regard as of vital importance to the Irish people. It is wonderful to see the measure going through the House in such a harmonious fashion considering the incredible bitterness the issue engendered through the years. I am delighted that a Labour Minister is introducing provisions to eliminate controls over the supply of condoms while recognising that they are harmless objects in their own right but beneficial in their effect.

The Health (Family Planning) (Amendment) Bill, 1993, embodies the commitment of the Government to a comprehensive effective strategy to combat AIDS. That is one of the priorities in ensuring that this Bill was brought forward speedily.

We recognise that the AIDS problem has become an epidemic in this country and is spreading at a considerable rate. A total of 1,368 people in Ireland have tested positive for HIV. This is a complete understatement of the situation. More blood testing has been carried out since 1992 on a random basis in hospitals and clinics than had been carried out previously. Proposals to include blood samples taken at sexually transmitted disease clinics and hospitals' in patients and outpatients should provide a much clearer picture of the prevalence and the spread of the infection.

I compliment the gay community on their responsible approach to dealing with this problem and particularly their emphasis on awareness in the community at large when other sections of the heterosexual community were turning a blind eye. Indeed, many sections of the medical community want to turn a blind eye to what is happening in our community.

I am extremely dissatisfied with the manner in which the problem of AIDS infection is dealt with in our prison system, where probably the greatest percentage of people who have been infected with the virus are to be found at any given time. There is a practice there whereby anybody tested positive for the AIDS virus is immediately penalised by being segregated in a section of the prison designated specifically for people with the AIDS virus. That is an entirely unacceptable approach to the problem. It should be dealt with in a humane way. The last thing that should be done is to point the finger, stigmatise somebody and confine them, making it obvious to the world both inside and outside the prison that that person is there because he or she is infected with the HIV virus. I urge the authorities, if they still have not dealt with the situation properly, to change their approach to dealing with the incidence of the disease in prisons.

The second point I want to make is in relation to the sexually active young population. We have been turning a blind eye to the fact that morality is not as certain sections of the community would like to imagine it is. We must recognise that people are becoming sexually active at a younger age. Awareness, particularly at school level, has become paramount. Every school should incorporate sex education as part and parcel of a life skills programme and it should be an essential part of the curriculum. The Department of Education should take on board the provisions we are in the process of implementing here today and ensure that a programme is implemented in every school, certainly every second level school, to ensure that the information is made available to young people as to the precautions that need to be taken. I do not in any way condone promiscuity, but people are sexually active at a young age and precautions must be taken. There must be awareness of the dangers of sexually transmitted disease and unwanted pregnancies. The relevant information should be communicated to the population at large at a younger age than it has been hitherto.

Ms F. Fitzgerald:

I wish to share my time with Deputies Dukes and Boylan.

An Leas-Cheann Comhairle:

Is that agreed? Agreed.

Ms F. Fitzgerald:

I listened to Deputy Kemmy speak of the greater realism in this House. He also mentioned that there was sadness. It struck me during the debate that there is a lot to be sad about because the energy and effort that has gone into this tortuous debate over the years has had implications in people's lives. There may indeed have been a great deal of personal tragedy caused by the failure to address this issue in a comprehensive way before now.

I welcome the provision in this Bill for free availability of condoms, but it is ironic that in taking this step the Minister is excluding them from the definition of a contraceptive, that is, the means by which people can prevent pregnancies.

The shift in public opinion is in terms of the openness of the sale of contraceptives. Undoubtedly this has been brought about in some measure by the tragedy of AIDS and the serious health questions which it poses. Again, I would congratulate the Minister on the approach he has taken in this area. I would congratulate him on the public information campaign which is in place at the moment. I would urge him, however, to consider further public information campaigns targeting women particularly. International research is showing that women are vulnerable to AIDS and they need to be well informed. My own experience, working as a social worker, has shown me that many of the most disadvantaged women in our society are not getting the sort of information and advice they need.

The shift in public opinion is not just in this area. We also saw it following the X case last year. I am convinced that increasing numbers of Irish people are quite clear that we must also be open and willing to deal with sexuality as a more complex issue, that we cannot pretend that crisis pregnancies do not exist. A number of Deputies mentioned this. We have to look at the question in a much more open way. That involves educating our young people in the whole area of life skills and sexual relationships. We know that young people are risk takers and that we have to discuss with them and inform them about the consequences of taking those risks. We have to give people the opportunity to make informed choices about family planning so that they can make the right decisions for themselves morally and healthwise.

Condom availability is just one piece of a jigsaw puzzle if we are serious about creating a healthy attitude about sexuality. Another piece of that jigsaw is the inclusion of the pill within the medical card system as a contraceptive rather than a cycle regulator, as has been the case. Undoubtedly these two measures will have benefits, but I would urge the Minister to develop the debate further, if not today then at a later stage so that we can take a more comprehensive view of this very important issue for Irish women and men.

All too frequently people have no proper access to advice and information in the whole area of family planning. This has been a completely grey area, unspoken of and not dealt with in a courageous way by the State or by the health service.

The Minister has made condoms more available and also the pill, but what about access to a broader range of family planning methods? Are doctors' consciences to continue to override the conscience of their patient? Does the Department know which doctors will provide a full family planning service, where there are gaps, and what steps are being taken to provide such a service?

To make informed choices people need information, and simply saying that the pill or condoms are more available does not address this. How is information to be made more accessible? How are health personnel to be trained to provide the wider service? I acknowledge the work of many in the medical profession in this area. Perhaps a survey of GP and health board plans for the provision of service could answer some of those questions. Such a survey should be undertaken as a priority.

Mention has been made of the many voluntary organisations who are working in the area of AIDS prevention. I pay tribute to them and to the work which they have done. I pay tribute particularly to the strategy commission and people like Dr. Walsh who have spoken out so clearly and have been so articulate about this issue in a society that does not really like to face up to the realities surrounding many of these issues and which has been reluctant to do so for many years.

Irish men and women have, however, been well served by organisations, often voluntary, and doctors who were courageous enough to provide family planning services when the State and the formal health sector did not want to know. I hope that their work can now be acknowledged. Their continued operation of emergency services in towns around Ireland is one indication of how far behind the health service has fallen in meeting the real as opposed to the perceived needs of Irish people.

I welcome the Bill. It is one important part of a response but only one part. We need the comprehensive approach which I have spoken about. I would urge the Minister to ask the committee looking at women's health needs in the Department of Health to look at the recommendations in this area in the Report of the Commission on the Status of Women. It is clearly a critical part of the issue of women's health. It is central and there is a range of actions which the commission suggests needs to be taken. I hope the Minister can initiate the sort of debate we need in this area and ensure that we have the widest possible and most comprehensive approach to this issue.

Mr. Dukes:

Like Deputy Fitzgerald, I am delighted that this Bill is before the House. It is another piece of the mosaic of commonsense that should have been in place a long time ago. It has taken us far too long to get to this point. I agree with other Members of the House who find section 2 very curious. It removes condoms from the definition of a contraceptive in the Principal Act. That is another illustration of the contortions of thought that have been brought to this issue year after year. We all know that condoms are contraceptives. To now find ourselves in the legal position where we have to pretend that they are not included in the definition of contraceptives illustrates how stupid our approach to issues like this has been.

I wish to make a few points. In the light of statements in the past few weeks in respect of opponents of this type of measure — and one was referred to in the newspapers this morning — we must make the point sensibly that there are very few cases in this area of human social behaviour where the law dictates conduct. It is more realistic to look at the world around us and conclude that it is the conduct of individuals in society that determine the law. Deputy O'Donnell put this very well earlier when she criticised people who claim that umbrellas bring rain. This Act, if it is passed, will not be an Act that will bring about a major change in the sexual behavour of Irish citizens. This legislation is required in respect of the way Irish people properly behave — this is the main wellspring of the inspiration for this measure — and the way the majority of Irish people see their role in life as partners in marriage, as partners in loving relationships and as parents, if they see such a role for themselves. That is why we need this legislation. There are other reasons and considerations which make it advantegeous to have this legislation, but that is the basic reason. Irish people are the same as people everywhere in the world. They have the right to freedom to make choices about their role as parents and that is the principal basic reason we should have legislation of this kind.

There have been many criticisms, and legislation like this brings the most extraordinary issues to the surface. I am sure other Members will have received documentation in the last few weeks from a body that styles iself The Canadian Information Service. I do not know, Sir, if you have seen the documents, but they are the most appalling piece of intellectual pornography. Reading the documents I had a vision of some crabbed, twisted individual getting on a high writing this material. This documentation is the most outrageous contribution to any type of debate and I raise it only to say that it is something we should ignore.

I am not happy that we are at a point where the Government considers it must refer to our concerns about AIDS to justify a measure of this kind in the same way as it was used to justify the last legislation introduced on this matter. The AIDS problem is a serious one. It is not the main reason for legislation of this kind. I will not go into the details and the scientific claims and counter-claims that have been made. I am not competent to deal with those issues and we have Administrations to do that for us. It is not true to claim, as Government advertisements now claim, that everybody in Ireland who is sexually active is at risk from AIDS. That is the most appalling nonsense to put across as a reason for this measure or any other measure.

It is far from the truth to say that everybody in Ireland who is sexually active is at risk from AIDS. That is patently not the case. To base an advertising campaign on that consideration rather than on the real facts of where the risks arise seems to be not just a waste of money, which is serious enough, but a distortion of the truth. In attempting to bring about one change in the way we think about sexual behaviour it runs a serious social risk of contorting our thinking in a totally uncalled for way. I do not mean to indicate any type of smugness or carelessness about the real threat that AIDS poses to our society. But I ask the Government to come clean on these matters, to speak about the issues as they are and not to use totally extraneous considerations, which are vital and worrying, to justify a perfectly sensible measure such as the one that lies at the heart of this proposal.

An old hobbyhorse of mine relates to the making of regulations. In section 6 the old procedure has been followed. I suggest to the Government that it modify it in one respect. There is provision in section 3 (1) for the Minister to make regulations prohibiting the sale or offering for sale contraceptives and so on at a place of a class specified in regulations. We know what the Minister has said he has in mind in that subsection, but it seems that if the Minister is deciding that certain places are classes of places where we should not allow the sale of contraceptives he should come before the House and argue that case.

I am not suggesting that the Minister should have to come before the House and get our active approval for regulations that deal with the standards of condoms. That is something that is properly in the realm of the expertise available to the Minister and our Administration. However, the question of deciding what types of places are not appropriate for the sale or condoms is one that should be brought before this House. It relates to people's access to contraceptives and the way they can use their rights as individuals. It is probably a vain hope to expect that the Government would consider this again. However, it seems to be a clear case where we can divide the types of regulations that fall to be made here between those that can properly be made in a purely administrative machine-like fashion and those that require a political decision because they relate to the way people behave and their access to exercising their rights.

Mr. Boylan:

I am pleased to briefly address this issue. I am totally opposed to the introduction of this legislation. I am disappointed that the Government and the Minister for whom I have a high regard, would try to con people that the items which are the subject of this legislation are not contraceptives, which of course they are. They have been promoted as if they were something young people could pick up like sweets or a bar of chocolate and that they are harmless. That is wrong. We are addressing the wrong issue here. We are giving the wrong signals and promoting promiscuity. We talk about this issue as if it concerns a whole body of people. We should consider this in terms of the Members of this House and their families and perhaps then we might seriously consider what we are trying to achieve here. We are putting pressure on honest, good, hard-working, decent people, who do not wish to be involved in this type of activity outside of marriage. Of course, there is pressure on those people and restraint must be exercised. People are prepared to do that for the benefit of a happy marriage later.

From where are the demands coming for this legislation? Who are the vocal group? They are not the majority of young people with whom I am involved and whom I meet, those people who wish to go out, play games, meet their friends or go to a disco. They will now be put under pressure by a small group of people. In all walks of society there are young people with problems. Problems occur in the best of families and family life is about supporting young people with problems. This problem existed when drink laws were liberalised here. When I was growing up, and indeed the Minister also, drinking in dance halls was prohibited. Suddenly the whole scene changed and there was a bar at the end of the dance hall. Young people were partaking of alcohol as it was freely available. They did not understand the consequences of this and they would become uncontrollably drunk.

Society has, by and large, come to terms with this and young people are restrained in their drinking. However, tremendous pressure did exist for many years. What the Minister is doing now is placing that same pressure on young people. I have no doubt he will be returning to the House in the future to rectify this but by then it will be too late.

It has been bandied about that this measure will prevent AIDS. There is not a scintilla of evidence to indicate that the use of these items will prevent AIDS. However, it certainly will promote sexual activity. The buzz words nowadays are "sexually active" young people as if that was the manner in which the majority of young people are behaving. That is not true and I take it as an insult to the young people who do not wish to behave in this manner. Young people want to go out and enjoy themselves. That is quite natural.

I am happy that the trend is for people to marry at a younger age. That is to be welcomed as they will grow up with their families. However, major problems exist in relation to housing which are not being addressed. Let us not be coy about this matter — there is temptation for young people in today's society. Young couples cannot get married because they cannot get a house. Naturally when they are keeping company there is a certain amount of pressure but the use of condoms is not the solution to that pressure. We must provide these young couples with proper housing where they can marry, live respectably and raise their families.

There is far too much acceptance of single parents, unmarried mothers and of couples living together who are not married. This is not good for society. I am not here to moralise but I am aware that if the Minister spoke to ordinary decent people the message they would give is that they want no hand, act or part in this provision.

Deputy McDaid lives along the Border where these items have been freely available. Can it be said that society in Northern Ireland is better than here?

Miss Harney:

It certainly is no worse.

Mr. Boylan:

It is certainly no better there and they have been available. Is the Deputy saying that if we introduce them here we will be better than people in that part of the country? People may smirk at my approach to this issue and say that I am totally out of tune but the Minister will find that I am not. I want to thank Deputy Fitzgerald, our spokesperson, for giving me the opportunity to express my view on what I believe is a totally out of line legislative measure on the part of the Government.

Mr. N. Ahern:

I wish to share my time with Deputy McDaid, Deputy Power and Deputy Flood.

Acting Chairman (Mr. Leonard):

Is that agreed? Agreed.

Mr. N. Ahern:

I am not in favour of this unnecessary legislation. I question why it is being rushed through this House on a bank holiday weekend. It is as if somebody was short of a packet of condoms for the holiday.

Miss Harney:

Deputy McDaid will give the Deputy a prescription.

Mr. N. Ahern:

Speaking on behalf of backbenchers on this side of the House, this is an issue on which many Deputies wish to contribute but cannot. I do not understand the all party agreement in rushing this Bill through as if it were emergency legislation.

Mr. Flanagan:

It is a Government measure. The Deputy should talk to his Chief Whip about it.

Mr. N. Ahern:

The Deputy should relax. I am making my contribution now.

Mr. Flanagan:

Stick to the facts.

Mr. N. Ahern:

One aspect that has amazed me is how some legislation takes months or even years to be brought forward. On the other hand legislation such as this, which has been before this House four or five times in the past 12 or 14 years, can be taken. It baffles me how these items get on the agenda so quickly.

I would not always have adopted the position I am taking today. Ten or 15 years ago I would have been campaigning for change in this area. I say that in case people try to label me. I would like to know from the Department of Health if this represents the end of the battle on this issue. Does it see this as the end of the road or will there be further legislation on the same issue in a year or two?

There is a moral background to this issue and we cannot get away from that. It will help to create and foster an attitude that casual sex is normal and it will put additional pressure on young people to engage in casual sex. I do not believe that a promiscuous society is beneficial. We are in a partnership Government which is a little like the sexual act in that it is supposed to be a loving, caring, sharing relationship. Both parties seem to have gone to great lengths to take on board the fears and objections of Labour backbenchers on certain issues. On other issues where people on this side of the House might have some reservations I would like some form of consultation or prior notice of issues such as this at parliamentary party level. The first I heard about this Bill was in the newspapers and I would like to think that programme managers would take on board our slight reservations on some issues.

Deputy Derek McDowell, in his contribution earlier, gave the game away on this issue. This legislation is only part of the overall thrust of the Government's or the Labour Party's agenda on social issues.

Mr. Flanagan:

No, the Government's.

Mr. N. Ahern:

I know the Labour Party is concerned with symbols and images and so on but this legislation is unnecessary because anyone who wants condoms can obtain them.

Mr. Flanagan:

Not true.

Mr. N. Ahern:

This is an indication of things to come and I wish to lay down simple guidelines in this regard. I do not wish to have other items on this agenda rushed through this House on some other bank holiday weekend when most of the backbenchers will be deprived of the opportunity to contribute.

Mr. Flanagan:

The Deputy will have to get 34 of his colleagues to join him.

Mr. N. Ahern:

The Department's recent campaign on this issue which cost £0.5 million is a squandering of money. AIDS is a problem but we must target the groups which are at risk. This can be done far more cheaply and effectively than by transmitting television advertisements into the homes of old age pensioners. I see no merit in that whatsoever. I ask that when future items on this social agenda are being introduced backbenchers on all sides of the House — and certainly the Government side — will be consulted in advance.

Dr. McDaid:

It is well know that I support this legislation. I have been quite vocal on this issue from the start and I am delighted it has reached this stage. I congratulate the Minister on bringing forward this legislation. It should put an end to this particular saga which has dragged on for 20 years. It is time to address the problem and face up to the facts.

When we consider the progress of the HIV and the AIDS epidemic in conjunction with the state of the European Community, and looking at the problem from a national and global point of view, we are led to one single conclusion: the epidemic is doing better against us than we are against it. We have done much but not enough to ensure that we have control over the problem. HIV is continuing to spread in already affected communities and is now reaching communities unaffected just a short time ago. The virus is so complex that scientists in this field freely admit we are still probably 20 to 25 years away from a cure or the development of a vaccine. I believe the major impact of this disease has yet to come.

How do we control the spread of this disease? My concern is that we as politicians must strive to protect our small country and take the necessary, and perhaps to some, unpalatable decisions and face up to the reality. We are a country of approximately 3.5 million people and should this disease get to grip in the heterosexual community, as it has done elsewhere, the epidemic could spread rapidly in a short period of time. I am not sure I understood Deputy Dukes when he referred to those here who are sexually active. Is the Deputy aware that in Zambia, a country with 13 million people, one million people now have the AIDS virus? Is he aware that in certain cities in Africa one in three people is HIV positive? The World Health Organisation has estimated that five million people in Africa will have HIV before the end of the century and millions of children will be orphaned. In Latin America more than one million people are affected with the virus; the position in Brazil is alarming and in South East Asia the number of people with the virus has tripled in the last 18 months to 1.5 million.

If there is no cure or vaccine on the horizon the central challenge to HIV prevention is to influence individual behaviour regarding sex and drugs. Of course education and information are required, but it is recognised that these are insufficient on their own to effect behavioural change. The World Health Organisation estimates that 5,000 people per day contract AIDS. In Europe at present 93,000 people have HIV, with 200 people per day contracting the virus. Epidemiologists have said that although the rate of HIV infection is falling in some parts of Europe, in others it is rising — we are in the latter category, although the increase here is not as great as in some countries.

It is of concern to me that although we are going through a period of harmonisation in Europe we are clearly divided on policy in this area, particularly on such questions as testing and targeting. Should people seeking insurance be required to have HIV tests and should health care workers be tested routinely? Unless we realise the prevalence of HIV in the heterosexual community the necessary precautions that are vital to prevention will not be taken. I ask the Minister, together with his European counterparts, to consider, perhaps in a pilot scheme in certain European cities, compulsory or blind testing so that there is some idea of the exact prevalence of HIV in the heterosexual community.

It is unfortunate that as regards prevention and cure no decisions have been made in Europe or Ireland on how or whether AIDS issues should be addressed in schools. We must not become complacent. Ireland and Europe must come to an agreement on how to deal with the risk of HIV to drug injectors. There must be a common policy on the use of zidovudine — AZT — and other anti-viral drugs. I urgently request the pharmaceutical companies of the world to collaborate with each other and pool their resources rather than compete in their quest to achieve a cure or vaccine. Let them not be lulled into a false sense of security by the seductive but completely false notion that HIV is not the cause of AIDS. Let me put it bluntly: people with AIDS are people who are infected with HIV.

Policies and laws must be based upon scientific fact and experience. I do not condone recreational drug injection or sex with multiple partners, but these behaviours are followed. We might prefer to believe that people in prisons do not have sex or inject drugs, but they do. We may find it difficult because of our cultural or religious traditions to explain condoms to school children, but young people, perhaps more than anyone else, must know how to protect themselves. To fight AIDS effectively we must deal with the world as it is, not as we would like it to be.

The key to the success of prevention programmes includes the creation and maintenance of AIDS awareness throughout the mass media. Prevention must include a general openness about sexuality, including sex education in schools, peer education and social support for drug users and other marginalised people, as well as condom promotion and availability. Many outspoken people who have written to me believe that sex education encourages early sexual activity, but the opposite is the case, as several well known studies have shown. I would like to deal further with this matter but as my colleagues wish to contribute I will conclude. I wholeheartedly support this Bill.

Mr. Power:

Due to the shortage of time I will address only a couple of important issues. On 8 July last year the then Minister, Dr. O'Connell, brought forward an amendment to the Family Planning Bill. At that stage I requested that a measure along the lines proposed here be introduced. Although it is a little late, this Bill is necessary and welcome. I encourage the Government to be more pro-active, to show the way and give a lead to the country. Section 2 amends the definition of contraceptive to exclude condoms. This is a joke and I ask the Minister to amend the section.

Since his appointment, the Minister has laid great stress on the AIDS problem and the difficulties in coming to grips with it. It is a growing problem not only in Ireland but throughout the world. Deputy McDaid mentioned Africa and the problems there. I visited the Cameroons last year and from my experience — it was not a sexual one — I would not be surprised if the people there do not wipe themselves out in the near future. This is a matter that will create serious problems for medics throughout the world.

Even if AIDS did not exist in Ireland this Bill would be essential. Regardless of how we perceive our children or our country. Tír na nÓg closed down a long time ago. The reality is that people are becoming sexually active at a much younger age. Despite the best efforts of parents, teachers and the Roman Catholic Church to encourage people to wait until they marry before indulging in sex, people engage in casual sex at a much younger age and more frequently. In view of those behavioural changes it is important that the Government makes condoms more widely available. I commend the Bill and I thank the Minister for bringing it forward. I also thank other Members for their contributions which I found quite interesting.

Mr. Flood:

I compliment the Minister for bringing forward this legislation so quickly in the lifetime of this Government. However, I have one or two reservations to which I will refer later. As part of our campaign against the spread of HIV and other sexually transmitted diseases this legislation is important and will help to tackle what is a serious issue. One or two contributors in today's debate may have, unintentionally, given the impression that AIDS and HIV are confined to a small, clearly identifiable section of our community. From examination of statistics here and elsewhere, this is not the case. It may be so if you can depend on your partner but, in view of intravenous drug abuse and increased sexual activity, one can no longer depend on a particular partner. That is a sad reflection on the world in which we live.

Much of the debate has concentrated on the question of AIDS and HIV, but we must take account also of unwanted and unplanned pregnancies, which is a tremendous and growing social problem. Public representatives who meet young single mothers with serious social problems resulting from unplanned pregnancies welcome legislation of this kind which helps to alleviate this problem. Rather than targeting young single mothers we should target their partners who give rise to the number of unwanted pregnancies and the social problems that arise therefrom.

In relation to my reservations, I would refer the Minister to section 3 which relates to the prohibition on the sale of condoms through vending machines in certain places. I know the Minister does not want to intrude on people's private lives. That is commendable. However, the introduction of regulations on the prohibition of the sale of condoms from vending machines in certain places intervenes in the ability of people to order their lives in privacy in matters of this kind. There should be no prohibition regarding the point of sale. I know this involves youth clubs and schools. I would prefer to see the people in charge of those places making the sort of decisions which the Minister seeks to make in regulations.

The Minister said that the removal of the controls would lead to the location of vending machines in appropriate internal locations, and then he went on to refer to the extent that inappropriate internal or external locations may not then arise. Will the Minister clarify if he proposes to prevent the provision of condom vending machines in the open, because if they are to be prohibited in the open that is fair enough, but if he intends to allow them to be placed in the open there is no necessity to restrict such machines in premises and it confirms the point I already made with regard to prohibition in certain places. I compliment the Minister on the Bill and I ask him to take into account whether it is necessary to have regulations.

Deputies Harney and McCormack rose.

Acting Chairman:

There are two minutes left. I do not know what agreement there was between the Whips. Nobody else from the Opposition has indicated. The Minister is to be called in less than two minutes.

Mr. McCormack:

I will be able to say what I want to say in two minutes. I am concerned with the thrust of this debate. I have serious reservations about the way the debate has been handled not only in the House but outside the House. I have no hang-up about the availability of contraceptives to mature people but I have reservations about the contributions of Deputies here, with the notable exceptions of Deputy Ahern and Deputy Boylan, not putting the other side of the story. This type of debate creates the impression that the availability of condoms or contraceptives in night clubs and discos is normal. Whether we like it or not that puts pressure on young people. The Minister and the media and everybody pushing the sale of condoms keep saying that condoms should be available in night clubs, discos and so on. As a parent of four teenage children I would ask, "Why should condoms be available in a disco?".

People meet casually for the first time in a disco. Are the legislators in this House telling young people that we have to make condoms available in discos in case they get the urge to have sex and that it is a normal thing to get the urge to have sex in a disco? That mentality should not be promoted in this debate. We should have more confidence in the ability of young people to make up their minds about this. We should not underestimate their ability to be responsible. We should be teaching in our homes and in our schools——

Acting Chairman:

I have to call the Minister.

Mr. McCormack:

——that responsibility in these areas would be a lot better than pandering to the idea that everybody must have a condom when they get the urge, or something like that.

Miss Harney:

Have a drink instead.

Mr. McCormack:

I very much regret this debate. The Deputy can laugh and she can do what she likes but I represent my constituency. The people of my constituency are telling me that it is time politicians stood up and spoke out as legislators. Demand for this Bill is not widespread and there are a lot of responsible people in this country. I am sorry I do not have time to further develop the argument.

Acting Chairman:

I understand that the Minister has agreed to give three or four minutes to Deputy Gallagher. Is that agreed?

Miss Harney:

On a point of order, I had indicated to the House——

Acting Chairman:

I explained that by order and by agreement with the Whips the Minister was to be called at 1.15 p.m. It is his option to allow time to any colleague.

Miss Harney:

We only had one speaker.

Acting Chairman:

Deputy Gallagher had expected to get in and the Minister was facilitating him. It is only right that he should be allowed this time. I do not want to waste any of the 15 minutes available.

Mr. Flanagan:

The agreement was that the Minister would reply to the points made in the debate. I have no objection to my constituency colleague speaking but I fail to see how he can take it from the time allowed for the reply to the debate.

Acting Chairman:

The Deputy is only wasting time. I am calling on Deputy Gallagher to avail of whatever time the Minister is providing.

Mr. Gallagher

(Laoighis-Offaly): I thank the Minister for making this time available to me. I welcome the general agreement to the Bill. I am somewhat bemused and saddened by the partonising views with regard to young people. Young people are well able to make up their minds on any issue. I resent the tone of some contributions which implied that they cannot.

This Bill was introduced for public health reasons. As Deputy McDaid said, while we may wish that the world was different, we have to deal with it as it is. I am aware that people would like values to be different but we have to cope with what we have. It is a good thing that there is tolerance of various values in our society. As a public health measure, I welcome the fact that this Bill is associated with a recent AIDS media campaign which has been launched, after some difficulty, on RTE. That campaign is a useful breakthrough in that it gets straightforward advertisements onto the national media. Given its relative success, the campaign should be extended to include a multi-media education which would be available to everybody.

With regard to the concerns of parents, one of the advertisements which struck me most forcibly in the campaign was an advertisement featuring the mother of an AIDS victim. I want to put the other side, to compare with some of the views given here today. In the advertisement Mrs. McCarthy says she tries to remember her son as the colourful person he was before he contracted AIDS, but all she can remember is the pain and suffering he had to endure before he died. She says: I urge all mothers to talk to their children about safer sex; I ask them to please, please, tell their children to use a condom if they are having sex; I would not wish any mother to see or go through what I did. That is a message from a parent, one that is being taken on board in the present campaign and in the Bill.

I commend this Bill to the House. Indeed it is long overdue as a public health measure.

Minister for Health (Mr. Howlin):

I welcome the views expressed by Members, in particular the positive views in favour of the Bill expressed by the vast majority of speakers. It is historic that such a Bill can go through with that measure of support, with a degree of calmness permeating the debate inside and outside this House that did not characterise previous debates on this subject.

I said in the course of my Second Stage contribution that this Bill was designed for a specific purpose, to deal swiftly with the availability of condoms in the fight against AIDS. I accept the view put forward by many speakers that the wider availability of family planning needs to be addressed in its own right. I am doing that as part of the national health strategy being developed and which I hope to have completed by the end of this year. I hope we will have the opportunity, either in the House or in the Select Committee on Social Affairs to debate that in due course. I take cognisance of the Second Report of the Commission on the Status of Women and of the views expressed by Members in the course of this debate.

As Members stated, standards for condoms are an essential safeguard. That is why I have included the provision for the establishment of standards in the Bill. The EC standard will become the national standard when it is adopted. Until then it is my intention to permit condoms to be supplied here only if they comply with the recognised high standard of another acceptable EC member state. I agree with Members that the monitoring of standards of condoms is essential also. I can assure the House that compliance with the standards set will be monitored by the National Standards Authority of Ireland.

Deputies Flanagan and O'Donnell mentioned the recent media coverage questioning the efficacy of condoms in preventing HIV, AIDS. I read the report and I read the wide range of reputable research projects which support the efficacy of condoms in the fight against AIDS. These reports come from international agencies such as the World Health Organisation, the Centre for Disease Control in Atlanta in the United States and from respected scientists and medical personnel worldwide. A huge body of evidence attests to the efficacy of condoms as a barrier to the transmission of the virus. These reports have been subjected to critical peer review and have been published in the medical and scientific press. Therefore, I have no problem accepting the findings of these projects and reports.

On the question of the perishability of condoms, raised by Deputy Flanagan, following long periods of storage, I am advised — I checked this since Deputy Flanagan raised the point — that there is no evidence that perishability is a problem.

Deputy McManus, in her forthright contribution, stated that this Bill would not in itself put an end to AIDS or to teenage pregnancy. I was a little taken aback at Deputy McManus's comment in relation to the media campaign, when she described it as bland, middle-aged; I can tolerate the "bland" but "middle-aged" I found to be a dreadful rebuff to the campaign. Indeed, the difficulty the campaign faces from a cross section of outside interests attests to the fact that it is a good, effective one that has drawn widespread positive comment from people nationwide within the short period it has been running but, no doubt, it can be improved.

Ms McManus:

I would rather wait and see.

Mr. Howlin:

I accept the Deputy's view that it will not put an end to AIDS. The liberalisation of condom legislation is part only, albeit an important part, of an overall strategy of public health.

I accept that education must be a major element of the strategy and I made that point last year when the precursor of this Bill was going through the House. I recognise the work of the AIDS Strategy Committee who have already stated that education programmes must play a major role in our strategy to prevent the spread of this virus. Education programmes take a number of forms, including targeted programmes aimed at specific groups. Deputies questioned whether the advertising campaign was sufficiently targeted. I decided deliberately that I wanted this message to go out to the community at large, not to any so-called vulnerable group. I know from my contacts that a great number of sexually active people consider themselves to be immune from this disease, to be invulnerable. Therefore, it is important to get the message across that this is not a disease confined to one tiny group in society, that, potentially, anybody who is engaging in unprotected sex, except with their partner who is faithful, is putting themselves at risk. The import of the message is that people engaging in sex on that basis should protect themselves.

In the resource centre at Baggot Street under the Outreach programme prostitutes are offered condoms as part of the programme. There are a number of other projects in place.

On the broader question of sex education in our schools, I propose to begin discussions with my colleague, the Minister for Education, who obviously has prime responsibility in this area, to prepare a programme. I propose also to refer to a number of other topics raised in the course of this debate regarding the extension of satellite drug clinics, the danger of the spread of AIDS in prisons and other matters to the AIDS Strategy Committee which I chair.

Deputy Frances Fitzgerald spoke about access to the full range of advice services. Obviously, that must be examined very carefully. I have noted her comments in that regard.

Deputy Dukes talked in terms of AIDS being the justification for this Bill. I repeat that I, as Minister, would have brought forward this legislation regardless because I consider it to be an important measure. It is doubly important in the context of the prevention of the spread of AIDS. The reality is that the use of a condom is not only an effective mechanism in preventing conception but is also an important implement in the fight against the transmission of a deadly virus. Deputy McManus succinctly put the contraceptive value of condoms as having no relevance to homosexual men, but they have a very important prophylactic value in preventing the transmission of disease in such circumstances. Therefore, on both counts, this Bill is important.

Deputy Boylan broke the consensus in the House in his very forthright contribution. I do not agree with the points he made and those of other Deputies in support of that line. The points made by Deputy Boylan were repeated by Deputy McCormack. I do not believe, at this stage of our development, we can lay down moral codes of conduct and pretend they are happening regardless of the reality. It is my duty as Minister for Health and that of this House, as a national assembly, to provide for the wellbeing and greater good of the people. I am firmly of the view that the Bill constitutes a realistic and genuine way of seeking to address those realities, even if they are unpalatable realities for many Members.

Mr. McCormack:

The Minister should not attribute to me remarks I did not make.

Mr. Howlin:

Would Deputy McCormack listen to people for once in his life——

Mr. McCormack:

I have been listening longer than has the Minister.

Mr. Howlin:

——and be open to the views of others. There is certainly a consensus within the community, as there is an overwhelming view prevalent in this House in relation to these matters.

Deputy Flood made a very important point, that there is no limit to the people who are vulnerable to the AIDS-HIV virus; it is not limited to any particular atrisk group. I accept that and endorse what he said in relation to the double value of the availability of condoms as a prophylactic against transmission of disease other than AIDS-HIV and also in the prevention of unwanted pregnancies which, as many Members said, is an important social issue that needs to be addressed in its own right. I hope this House will have an opportunity to do so in the not too distant future.

In regard to the regulations I intend to introduce, I do not intend bringing in regulations to prohibit the siting of condom vending machines. I shall leave that issue open but, if it is drawn to my attention and I accept that vending machines are sited in unsuitable places, and feel it necessary to take action I want to have the legal power to be able to do so. I am strongly of the view that there will be no need to draw up such regulations because people will show sensitivity in this regard. The regulations to which I am referring pertain to machines located outdoors which are to be found in many countries. I have no intention of prohibiting such machines.

In conclusion, I welcome the fact that the Bill has been broadly welcomed. It is an historic Bill and closes a chapter which it has taken a long time to close. I hope it will have a speedy passage through both Houses.

Question put and agreed to.