Seanad Éireann debate -
Thursday, 14 Dec 2023

I am pleased to introduce the Bill to the Seanad. As colleagues will be aware, the Bill passed all Stages in Dáil Éireann with broad support and today I am presenting it to the Seanad for consideration. In doing so, I am cognisant that this issue is not new to this House and that legislation with a similar purpose and intent was passed by the House in April of last year. In this respect I acknowledge the contributions of Senators and Together for Safety for their work in this area. It is evident that this Bill builds on their efforts and I am confident that with the passing of this legislation, we will achieve our mutual aim of safe and unimpeded access to termination of pregnancy services.

The legislation delivers on the programme for Government and fulfils a long-standing promise, first made in 2018, to provide for safe access zones. I am fully committed to ensuring that termination of pregnancy services can be accessed quickly and easily by those who need them, without judgment or bias. I have made substantial progress in delivering on that commitment and today marks another important step. I recently announced the provision of termination of pregnancy services in five additional maternity hospitals. This will bring the total number of hospitals providing early termination of pregnancy services to 17.

It marks a significant step in the provision of full services in all 19 hospitals. There has also been a small but steady increase in the number of community providers, which currently stands at 434. The legislation will help to consolidate and protect that progress by ensuring that women can access services free from intimidation and harassment, and service providers and their staff can provide the services.

This is, of course, a complex area of law seeking to balance competing constitutional rights. This Bill is not about criminalising lawful protest. It is not about shutting points of view. It is recognised that while it is vitally important that the rights of women and healthcare providers are respected, it is equally important that rights such as those of assembly, expression and religion are impacted only to the extent where it is necessary and proportionate for the objective to be achieved. With this in mind, officials in my Department engaged extensively with the Office of the Attorney General and other relevant stakeholders to ensure that all areas of this legislation were considered thoroughly. Moreover, I listened carefully to the robust and insightful contributions of Deputies during the passage of the Bill through Dáil Éireann, and re-engaged and re-examined, as necessarily, in terms of the issued raised. It is, therefore, my belief that the Bill, as now drafted, strikes an appropriate balance between the relevant human and constitutional rights involved. Additionally, on foot of Committee Stage discussions, I introduced a Report Stage amendment that provides for a review of the operation of the legislation after a period of 18 months. This will provide a mechanism to identify issues that may arise with the implementation of the Act.

It is important to note that Ireland is not unique in introducing safe access zones. Safe access or buffer zones have long been a feature of the legislative framework in Canada, Australia and certain states in the United States. More recently, and closer to home, the Isle of Man introduced legislation providing for such measures in 2019 while both Scotland and Northern Ireland have or are in the process of following suit. Furthermore, the introduction of safe access zones here in Ireland is supported by clinicians providing the service.

The main purpose of the Bill is to address and mitigate, insofar as possible, the potential for a person's access to a termination of pregnancy to be impacted or influenced at the point of access. It will also provide additional assurance to healthcare providers should their services be the target of specified conduct that could interfere with their service provision.

I will now take colleagues through the Bill. Section 1 is a standard provision containing definitions of the key terms in the Bill. As colleagues will be aware, the Government decided to provide termination of pregnancy services within existing mainstream health services. This was done both to embed the provision of termination of pregnancy services into primary, community and acute services, and to ensure services could be provided to those needing them in relative anonymity. In line with this policy, the safe access zone legislation will not highlight the specific sites at which services are actively provided. Rather, it will create safe access zones 100 m from the entrance or exit to a premises where obstetricians, gynaecologists and general practitioners provide services. This will include such facilities as consulting rooms, family planning clinics and women's health clinics. The zones will also apply to hospitals that provide acute inpatient services within the meaning of section 51 of the Health Act 1970. The zones will apply in certain circumstances to shared properties and to private property.

Section 2 prohibits certain conduct in the vicinity of healthcare premises that may provide termination of pregnancy services, which intentionally or recklessly impedes access or influences the decision of a person in availing of, or providing, termination services. It is not intended to be a general prohibition on expression, assembly or protest in respect of termination of pregnancy services. The overarching aim of this provision is to protect people's access to a lawfully available healthcare service and protect their decision to access termination of pregnancy services from unsolicited influence. Likewise, this also protects healthcare providers in their provision of services and their decision to provide termination of pregnancy services to ensure the availability of service.

Section 3 sets out exemptions that may apply in the context of prohibited conduct within safe access zones and the corresponding offences. In doing so, it further acknowledges and promotes, on a proportionate basis, the balancing of various human and constitutional rights. The section makes it clear that the Bill does not impede, impact on, prohibit or criminalise anything done by healthcare workers and other staff of the healthcare provider in the normal function of the health service.

With regard to the right to protest, the proposed legislation does not interfere with the right to advocate in favour of or against abortion, apart from in the limited areas covered by safe access zones and in the limited fashion covered by the concept of "prohibited conduct". As such, the prohibition is not on the right to protest but on exercising that right of protest within a safe access zone in a manner aimed at interfering with a person's access to a facility for the purpose of availing of or providing termination services.

The section clearly outlines that otherwise lawful protest outside the Houses of the Oireachtas is not prohibited, provided it is not aimed at a specific healthcare facility. The section also ensures that conduct that would otherwise be lawful, which occurs within a public place, meaning a building of worship, is not prohibited. This is to protect, for example, sermons that may be given during church services. This exemption would not apply to, for example, grounds outside of a church within a safe access zone to avoid a situation where protestors use the grounds of a church or a similar location to circumvent the prohibited conduct. The aim of this overarching approach is to ensure the effect of the proposed legislation on the rights of those affected is proportional to the objective sought to be achieved.

Section 4 sets out the powers of An Garda Síochána. The section contains a requirement for a Garda warning as a precursor to the commission of an offence. This mechanism was introduced to enhance legal certainty and protection of rights so that persons at risk of offending through commission of prohibited conduct are clearly made aware that they are engaging in prohibited conduct and that further conduct would amount to an offence. This provides the person concerned with the opportunity to regulate their behaviour and avoid committing an offence. The criminal offence only occurs if the person engages in prohibited conduct after the warning is issued. In line with a recommendation by the Joint Committee on Health, there will also be a requirement to record the warning in writing. The section also includes relatively standard powers of arrest and requirements to provide a member of An Garda Síochána with a name and address for the purposes of recording a warning.

Section 5 sets out the penalties arising for offences under the Bill that may be prosecuted summarily. Penalties have been provided on an escalating basis where harsher penalties may apply for repeat offences.

With regard to section 6, following Committee Stage discussions, I agreed to introduce a Report Stage amendment providing for a review and a report on the operation of the legislation after a period not later than 18 months. This provision also required that the findings of this review would be laid before the House of the Oireachtas.

Section 7 is a standard provision regarding expenses incurred by the Minister in the administration of the Act.

Finally, section 8 is a standard provision containing the Title and commencement date and will provide for commencement on a date prescribed by the Minister by order.

Today affords us the opportunity to make a real difference in people's lives. It is a milestone in ensuring that our friends, colleagues and family members are treated with consideration and empathy at a time when they most need care, and that they are afforded the necessary dignity and privacy to make their own decisions. Essentially, it allows us to put safeguards in place so that women, and service providers and their staff, can access lawful healthcare services without intimidation. In its progress through Dáil Éireann, the legislation generated vigorous debate from across the spectrum of opinion. I am aware that are those in this House who will have reservations about its impact. I look forward to hearing contributions from Senators.

The Minister is very welcome. I am glad that the day has come where this legislation has come before us and we will progress it through the Seanad. As he alluded to, he has discussed this topic here on a few occasions. He has behaved very constructively with the Opposition and everybody here who have tried to improve the situation and he has come back to us with really good legislation. I commend the Minister and his officials in the Department on diligently working on this and delivering robust and workable legislation.

The Minister's contribution was littered with words like "privacy", "dignity", "human rights" and people accessing lawful health services. That is what this Bill is about and is what we are all trying to achieve. I commend everybody involved in Together for Safety group because they have not let this issue go for all these years.

As the Minister rightly pointed out, this legislation was promised in 2019. It arose following the report compiled by the Joint Committee on the Eighth Amendment of the Constitution and we proceeded with a referendum. Some people thought that this is where the issue of termination services lay, and we had gotten over that hump and could all move on but of course many gaps remained. Safe access zones was one of the gaps. I am glad that this gap is being closed now and, together with the free contraception scheme, we are delivering on the recommendations of the committee.

As the Minister alluded to, it is a very difficult to strike a balance between constitutional rights and human rights but the right balance has been struck in this legislation.

The Minister has thought long and hard about how we go about it. The clause that has been added regarding the review is very good. It will allay some fears about the abuse of the legislation or the potential for harm that comes with it. Hopefully, we can move it ahead and move the debate on in a respectful manner.

I want to talk about the impact of the lack of safe access zones around hospitals. We have heard some really awful stories. I was contacted by a woman who unfortunately suffered a stillbirth. She was in one of the maternity hospitals and obviously, it was a hugely difficult and traumatic experience for her. When she was in the hospital, her elderly parents came from Donegal to visit her. Obviously, they were incredibly upset that their first grandchild had died in a stillbirth. She told me they were met with white coffins, crosses and people harassing them as they were going in to see their daughter. Hopefully, situations like that will not happen again.

I welcome the Minister to the House. I can see how upset Senator Clifford-Lee is. These situations are real, they do happen and they do affect people. Whatever one's view is on the termination of pregnancy and what was decided in the referendum, once the law of the land is in place, it needs to be respected. People need to be able to access what are legal services, without being harassed. People are going into hospitals as a result of miscarriages, stillbirths and having to have a termination. They should be able to go in and out of the hospitals in this country without any intimidation, hassle or protest. It is a simple ask. Irrespective of the views held on these issues, I think most people would respect the fact that we should be able to access medical services without fear of harassment or intimidation. That is what this legislation does. As has been said, the reviews that the Minister has put in place as part of the legislation are very welcome. I know the legislation has been tricky and difficult. People like me were pushing very hard to have it expedited for good reason, because of the situations outlined by our colleague, and others that we are aware of. Together for Safety has done a lot of work in this area. The health committee has also done a significant body of work in the engagements we have had. The legislation being brought forward by the Minister is reasonable. It takes cognisance of the difficulties and the challenges that exist. It is designed to protect people. Nobody goes into a situation like this by choice. It is usually the result of very difficult circumstances. I think the legislation is balanced, I thank the Minister for bringing it to the House and I sincerely hope it passes without any difficulty.

The next speaker is Senator Mullen. Before he starts, I welcome the friends and supporters of Sr. Catherine Lillis, the Columban Sister who will be presented with the seventh Oireachtas Human Dignity Award later today. They are all very welcome to Leinster House. We thank them for being here, and wish them a very happy and peaceful Christmas.

I welcome the Minister to the House and apologise for the fact that I will be unable to remain for the duration of the debate. I will obviously scrutinise it very carefully later on. I am attending an event involving the Human Dignity Award presentation. Senator Keogan will be there as well, so we will not be in a position to oppose this Bill on Second Stage. I assure the Minister that this Bill deserves to be opposed. It will be opposed and extensively scrutinised on Committee Stage, and extensive amendments will be proposed.

Notwithstanding the courtesies of the House, I have to say - and I hate to use such strong language - that this is disgraceful legislation. We have been presented today with some kind of sanitisation of this legislation as being some kind of respectful balance, having regard to people's right to access abortion which is now legal, tragically, and respect for people's right of freedom of assembly as guaranteed under the Constitution. I am reminded of the British Government's approach in asserting that Rwanda is safe because it says so, and that it will legislate to say so. These kind of guarantees that this is legal are summed up in the language used by the Minister today that it is not about criminalising lawful protest. Indeed, it is not, because the Minister proposes to make certain protests unlawful. How can you criminalise that which is lawful? Those are the kind of weasel words that are designed to reassure people that there is something reasonable about all of this.

The reality, in our country, is that we do not have abortion clinics per se. Abortion is available and it happens in GP surgeries and hospitals. People who access these places enjoy complete anonymity. The record of those who would witness, for whatever reason, to the injustice of abortion outside facilities where it takes place is that they are actually very few and mostly very respectful, which is what we would all want. What this Bill is actually about is finishing the work of the legislation for abortion five years ago in 2018. It is to crush dissent and make sure that the voice says that the unborn child is a human being that ought to be respected, cherished and welcomed into the world, the same as a child in Gaza or any other vulnerable child in any situation, is not to be heard. What we have had is the disgraceful situation of Government officials and representatives caving in to special interest groups that want to silence dissent. I cannot believe that what is provided for in this Bill is constitutional, when one considers that the deputy Garda commissioner appeared only a year ago before the health committee and called for signage to be erected outside facilities where abortions were being committed, on the mistaken assumption that hospitals were the main areas where services are provided at this juncture. Indeed, we heard the Garda Commissioner in the past saying that such legislation was not needed. The claims that people attending hospitals were being impeded by a lobby group were effectively undermined by the hospitals themselves. For example, Cork University Hospital released a statement to the effect that it had not received any complaints from patients regarding the protests.

What we see here is an example of what Hannah Arendt called the banality of evil, where something really wrong and unjust is being done by some very respectable people, with great sanitised language and with pretensions of respect for democracy, freedom of expression and the free exchange of ideas. It is nothing of the sort. It is a desire to crush dissent, even from among the small number of people who might want to witness outside a medical facility that people could be attending for any purpose, or where there is no possibility of a person being personally intimidated or accosted, but where there might be the possibility of somebody seeing a smile, getting an offer of help or initiating a conversation that might lead them to choose not to have an abortion, with a life saved as a result. That is not to be tolerated because in the new Ireland, it is not a good news story if somebody decides not to have an abortion. The Government has abandoned any desire to even talk about reducing the number of abortions.

I remember when Bill and Hillary Clinton were advancing abortion in America. At that time, they said they wanted it to be safe, legal and rare. In today's Ireland, you are not allowed to use that language. You are not allowed to say it should be rare. Why should it be rare? It is a person's choice. The unborn child is a nothing in the eyes of these people. That is a tragedy for our country. Any legislator who supports that situation, and any legislation that supports the ruthless crushing of even respectful witnessing to the dignity and the humanity of the unborn, is doing their country a major disservice. If the Minister wonders why politics and politicians are brought into such disrepute, it is because legislation like this says to a significant proportion of people in our country that politicians really do not care about what is right and wrong. They just go with whatever the special interest groups that are most influential at a given time want, and they give it to them on a plate. It is shameful legislation and it will be opposed on Committee Stage.

I have serious concerns about this Bill. I believe its inevitable outcome will be to deny women the option of availing of lifesaving supports when they need them most. This criminalisation is far too sweeping, particularly when considering the sheer number of safe access zones that this law would create, covering every GP clinic, hospital and family planning centre, irrespective of whether they provide abortions. In England and other jurisdictions where similar laws exist, we have seen cases of people who have been arrested for silently praying in the vicinity of abortion clinics. What guarantee is there that people would not be arrested here for praying quietly? If a small group or an individual were to stand outside Beaumont Hospital and pray a rosary intended for the sick or the healthcare workers, they would be well within their rights, but if they offered intentions for the unborn child, they would suddenly fall foul of this law and be treated as having committed a crime.

While the impact of the Bill on religious freedom is relevant, I am also concerned that it would forbid the possibility of any positive efforts by private citizens and good Samaritans to offer women in unplanned pregnancies meaningful supports at a time they need it most. Under this law, a person would be prevented from quietly standing in a public place with an optional leaflet in hand, the contents of which simply offer information or supports for women in unplanned pregnancies. I am not describing situations where leaflets are offered unsolicited but rather where a person just wants to stand there harmlessly. We know that is done in other jurisdictions and it has filled a gap by providing women who are considering an abortion with a much-needed lifeline.

If we want to be a compassionate society that respects women, we need to ensure that no woman ever feels she has no choice but to have an abortion. That is too often the case at present. The State-run My Options hotline acts as little more than an abortion referral service. It is well established, both on the record of this House and outside it, that there is no evidence that legislation such as this is needed. Senior gardaí have repeatedly stated that existing public order legislation is sufficient to defend people from harassment and intimidation and none of the major hospitals in this country have reported anything approaching the scenarios pro-abortion campaigners claim are a daily occurrence. While such campaigners may smugly remind pro-life persons that the referendum is over, it remains a fact that one third of this country never wanted abortion introduced in this country and their voices are valid and must be counted and allowed to be heard.

We have in this country a tradition of silent and peaceful prayer vigils that often take place in the vicinity of hospitals as a way to pray for those suffering inside. That is what this Bill seeks to ban - not harassment but prayer. Archbishop Eamon Martin was absolutely correct when he said that such a move would "further silence the voice of the innocent unborn" and increase fears for the freedoms of religion and speech. He asked, "What next? How long before it is deemed unlawful to openly express in Ireland the reasonable opinion that there are two lives in every pregnancy worth protecting – the life of a mother and the life of her unborn child?" I fear that this Government is putting through this House a raft of legislation that when combined, will severely curtail our human rights and civic freedoms.

This Bill will not protect women. It will deny them the opportunity to avail of assistance to willingly receive help and counsel when it is most needed. It seeks to ruthlessly punish all those whose conviction or faith leads them to stand up for the most vulnerable in our society, namely, unborn babies. It is yet another Government Bill that seeks to punish opposition to the prevailing narrative, to copperfasten the supremacy of the majority over the minority opinion. It is a terrible proposal and I will not support this Bill.

Senator Keogan mentioned that people will no longer be allowed to stand silently. Senator Mullen said there is no issue and nothing is happening in Cork. I have in my hand a tweet from Senator Mullen that reads, "I encourage people in Ballinasloe and the surrounding area ... to engage with medical and other staff ... to discourage the practice of abortion and to never let up". That is a tweet. We know the damage that social media does and we now have a Senator on social media encouraging people to stop and interfere with staff in their lawful carrying out of services in this country. It is an absolute outrage-----

-----and disgrace that any politician would do that to staff who are going about their business. We had a referendum and not everybody voted in favour, but this is the way laws work. We vote, and take it on the chin if we do not get what we want and the laws are passed.

I am encouraged by this legislation. Unfortunately, only one in ten GP practices engage in allowing women to have abortions, as is their legal right. I am also delighted that Portiuncula University Hospital, Ballinasloe, has, as of last week, started to allow women in Galway to have abortions at the hospital. I am thrilled with that news.

We have to do an awful lot more. This Bill will give some comfort to medical staff. Counties in the midlands and the north west have some of the lowest abortion rates. That is not because women do not want abortions but because they have to go elsewhere. There are only three GPs in some counties. Sligo, Roscommon and Mayo are enormous areas of the country where people cannot get access to services. We as a country pat ourselves on the back because women no longer have to travel to England for abortions but they should not have to travel anywhere to get a medical service to which they are entitled under the law.

As the Minister and Senators Clifford-Lee and Conway said, the legislation was supposed to be brought in along with abortion. I acknowledge the volume of work that the officials in the Minister's Department have done to get the Bill to this point. There has been nothing but support in getting this legislation over the line. I am one of 12 Senators who signed legislation. I thank Senator Gavan for doing such work on a cross-party basis. Representatives of Together for Safety are in the Gallery and I thank them for all their work. That is what pushes things on. It is that kind of activism that motivates a government to take the next steps.

It is also important to mention that it is not just about the provision of abortion services. That is what we are here to talk about but as a Government, we have done many other things, one of which is the expansion of free contraception schemes. That was something we also put into the programme for Government and the Minister has taken the steps to provide that money. We now have a situation where people can get abortions and we have ensured that cost is not a barrier to contraception. That is massively important. I know it was a recommendation that when abortion is introduced, follow-up care should be assured so that people do not feel that contraception is a barrier for them in the future.

There has also been the elimination of VAT on period products. Some €10 million has been provided for publicly-funded IVF treatment. VAT has been taken off HRT for menopause, which, as the Minister knows, is a topic I am enormously passionate about because women of all ages need treatment. I also believe it would cost very little to provide free HRT so I will keep pushing on that and I hope I will have success in that regard. Of course, there has also been phased expansion of the complex endometriosis service in Cork. Almost €1 million has been provided to develop women's health hubs. The Government has done many other things which are too numerous to mention. Under this Government, we have seen a real dedication to women's health and long may it continue.

Listening to our colleagues, Senators Mullen and Keogan, brought me back in time to 1983, when I first got involved in political action. I campaigned against that awful eighth amendment. Their speeches brought me back to a time when they were the dominant voices. That suffocating oppression of women was mainstream and so strongly in place that it was a horrendous time. As a result, each year thousands of women were forced to go elsewhere for essential healthcare, to access abortion. It is good to see we have come a long way and it is important to acknowledge that on a day like today.

The history of this Bill goes back five years to when, after the successful repeal referendum, my colleague, Deputy O'Reilly, was speaking to Simon Harris, the then Minister for Health, and emphasised the importance of getting safe access zones in place. The Minister said we needed to get this Bill in place first but would then follow up with that legislation. It has taken five years, which is a long time.

I do not believe we would be here today if it were not for our colleagues in Together for Safety. I acknowledge Karen Sugrue here today, her good colleague Yvie Murphy, who could not make it today but wanted to be here, and a host of other people in Together For Safety who campaigned relentlessly on this issue. They were kind enough to allow me to introduce a Bill and I did it on a cross-party basis. I acknowledge the co-operation and support of all Senators across all parties to enable us to pass all Stages in the Seanad, ramp up pressure and ensure we have this Bill here today. While it has been extremely frustrating to wait so long, I acknowledge the legal complexities and the work of the Department officials here. I was able to engage with them at one of the health committees, in particular – I think two actually. I understand it was a complex process and I give them credit for the work they have done to bring us this far.

The Bill effectively mirrors the goals of the Bill we got through the House. There are concerns around the warning system. My colleagues in the Dáil raised that on Committee Stage. They tried to work with the Minister. It is something we might have another look at on Committee Stage but we very much support the Bill.

I want to see safe access zones introduced as soon as possible to ensure people can get safe access to the services. It is not true when Senator Mullen says people enjoy anonymity. They do not enjoy anonymity. They are trying to access essential healthcare and abortion and we know there have been instances of intimidation and appalling white coffins and crosses outside hospital settings. It is not good enough.

The Bill would create a 100 m safe access zone around any healthcare premises where termination of pregnancy services may be provided. It would prohibit a person from obstructing or impeding access to a relevant premises where people are availing of or providing termination of pregnancy services. It would make it illegal for a person to communicate material or otherwise engage in conduct with the intent to influence the decision of the person availing of or providing termination of pregnancy services. It would give the Garda the power to issue a warning to any individual it believes is engaging, has engaged or will engage in such conduct. Where a person receives a warning but continues to engage in that activity, he or she may be arrested without a warrant. This would undoubtedly aid women in gaining safe and unhindered access to lawful termination of pregnancy services.

It is important to clarify what the Bill does not do. It does not seek to ban protests within 100 m of the Houses of the Oireachtas, and rightfully so. It does not prohibit the provision of information regarding termination of pregnancy services, whether provided by or on behalf of the relevant healthcare provider. Those are important protections when trying to balance the right to protest with the right to access healthcare services without fear or threat.

While the Bill addresses some concerns that have hindered the development of accessible termination of pregnancy services, it will not address all concerns. The independent review of the operation of the health Act 2018 highlighted a number of issues the Bill does not deal with. The report identified clear regional disparities between services. We welcome the improvements that have taken place recently but, as Senator O'Reilly has pointed out, there are still significant sections of the country where people have to travel for services. That is not good enough. The report pointed out we are not training or recruiting enough doctors. It identified the south east, north west, midlands and Border counties as particularly under-served.

The issue of the mandatory three-day waiting period must be rectified. The position of the World Health Organization is that a mandatory waiting period should not be required and the evidence does not establish any benefit to mandatory waiting periods for women. The report cites the unplanned pregnancy and abortion care study commissioned by the HSE, which showed respondents wished to access care as quickly as possible and did not perceive any benefit in a three-day waiting period for reflection on their decision. Respondents stated they felt certain of their decision, had not taken the decision lightly and had reflected on it prior to arranging an appointment with a GP or community provider. The three-day waiting period has to go. It is an insult to women. I am disappointed it appears the Government will not act on that. I ask it to reconsider that point. Researchers found respondents were consistent in their view that the three-day wait had next to no impact on their decision-making process, regardless of the length of time it took to make the decision. We need to see a clear plan from the Government on progressing the recommendations of the independent report.

I am happy this Bill is here today and I want to see it pass as quickly as possible. In Limerick we need to see it passed before the next Lent season because that is when it is ramped up outside the maternity hospital. I hope we will have the co-operation of all Senators. I am sure we will have that from almost all Senators and will get this Bill passed swiftly in the new year. I look forward to working on that.

Thank you. I welcome this discussion and the Bill. I was proud to be part of the cosignatories group on the legislation we proposed in here. I do not want to say I am tickled pink that it is finally coming through but this is significant legislation. We have waited five years for it. The Bill is about patient safety and the well-being of those going into hospitals or healthcare settings, as well as the well-being of doctors, GPs and their staff. We are not just talking about the people who want to access reproductive healthcare but also staff.

I have spoken to those who have sought to access healthcare and to providers. I cannot speak for all of them but those I have spoken to feel this will be beneficial. While we may not have floods of protests outside of places, it has a chilling effect and that is what it is designed to have. People have had to make decisions to go into access reproductive healthcare even though they know there is a protest outside, particularly, as has been referenced, in Limerick. When people access this kind of healthcare, they cannot decide to wait until next week or until another day or hold off until the protests are not there. Often this healthcare is extremely time-sensitive because of the legislation, or perhaps for personal reasons. People do not have the luxury of waiting until the protesters are no longer outside. No one should have to make a healthcare decision based on waiting for when protestors will not be outside. That is not the best way to do that. It can be frightening and worrying for prospective patients.

I hope and believe this Bill will address the chill effect the protests are designed to achieve. The actions of these protesters are rooted in judgment and not in compassion. We have seen the strategy used for decades in the US, the UK and elsewhere in Europe. I cannot comprehend how people feel they have a right to cause hurt and upset instead of showing care and compassion for fellow people. There are legitimate means, I believe, to express disquiet over abortion in Ireland which do not hurt, impede, insult or upset people as they access necessary healthcare.

A previous speaker referenced a woman who had to walk by small white coffins. I have also spoken to women who were not even going into a hospital but who contacted me.

I think I was actually in the Chamber when I got a text message to say this woman had walked by a protest and there was a white coffin outside. She was slightly older and she said it just brought what she had experienced flooding back to her. She had never gone for an abortion or done anything like that, but she had lost a child a long time before that. She said to me that she thought we were in a different place in Ireland now. I think this will be really important. It is not just people who are trying to access abortion or reproductive healthcare. There are people who are walking by who may have lost a very wanted child for whom that pregnancy was not viable or did not continue. This is a very difficult process for them when they see those small white coffins, which are designed to be so incredibly evocative. I do not believe they should be used in a way to intimidate, harass or punish people. I cannot even imagine what it is like to have to look at one of those small white coffins and be reminded of something that happened in their lives. I cannot understand how people feel that is an acceptable, fair and compassionate way to treat people. I cannot wait for this legislation to go through.

I will not necessarily drag on because everything has been said. I was struck by a previous speaker who said this is designed to finish the work of the legislation begun five years ago. That is absolutely right. This is part of the legislation that was promised five years ago. That is exactly how the system works. We say we are going to do some legislation and then at some point in the subsequent years we get the legislation done. I think that is perfectly right and correct. I am glad that we are working to finish the legislation as was promised five years ago.

As has been alluded to in this House, other pieces still need to be looked at including the three-day wait period. Women are still forced to travel to the UK in cases of fatal foetal abnormality. There is a little bit more to do. It is absolutely right and proper that the Minister for Health is here today finishing legislation that was promised to us. That is great. I do not know why there is an issue with that. I am thrilled if I may be so frank about it. I know the Minister is taking this very seriously. I hope this legislation will give comfort to other providers.

We had a discussion about some of the providers, particularly in the midlands and north west, who feel they cannot currently provide access. It may be related to the threat of protest outside. Some of the providers I have spoken to fear that if they were to be known as providing abortion care in their clinics in some rural parts of Ireland, they would become a target of protests. People should not have to decide not to provide healthcare in an area because of the fear that it would bring disrepute to them and their clinic. I spoke to a doctor who said she cannot have patients coming for other kinds of healthcare and then see protesters outside. She said she was not willing to take that risk. I hope this legislation will provide comfort to her and other GPs that this will not be allowed to happen.

I was struck by the comment about on this. A woman spoke to me. She was going into hospital for a reason completely unrelated to reproductive healthcare and she saw a small quiet gathering outside. She recognised someone in it and she thought, "Oh my God, I know that person." She was just going into the hospital for a perfectly routine thing and recognised someone outside. Of course, someone at some point will recognise anyone. That always struck me. As I said, she was not going in for any reproductive reasons but she recognised somebody outside. We could probably pop a pin into the idea of anonymity in Ireland because someone knows someone somewhere. I am not entirely convinced that people would just be able to scoot in and out and not recognise someone outside.

I thank those involved in Together for Safety, Karen, Evie and Jan O'Sullivan, a former Labour colleague of mine, and all my fellow repealers who have been working on this for a long time. As we have said, this is finishing the work of the legislation that was promised five years ago and it is about time. Hurrah for that. This Bill has been a long time coming. We need to get our act together.

I was struck by what Senator Gavan said regarding the timing of this legislation in the new year. It had not even occurred to me that there are particular times of the calendar year when these protests might ramp up. It would be useful for the Minister to consider the timing of getting this legislation done. That would be very welcome. There was a very clear "Yes" vote in the referendum and we had a very clear promise that there would be legislation. I am really pleased that we are getting it through the Seanad. I look forward to Committee Stage and engaging with the Minister on some of the issues Senator Gavan raised that we think could be tightened up. I am thrilled that we are here. I am thrilled that we are finally getting there.

The Minister is very welcome to the House. I wish him and his family a very happy Christmas.

This legislation has been a long time coming. I am glad that it has finally come before the Seanad. I pay tribute to the incredible work of the Together for Safety campaigners. Their dedication and persistence have helped get us through to this crucial stage. I also commend the Minister on his work on it. Senator Gavan deserves the utmost credit for working with activists to bring forward the Private Members' Bill on this issue, which advanced the issue considerably.

In 2018, the public voted to repeal the eighth amendment and they did so on the basis that it would be free, safe and legal. In Irish democracy and constitutional law, the people are sovereign and no group, no matter how strong their convictions may be, can veto the people's mandate. We must be unequivocal. Abortion is healthcare and no one has the right to interfere with another person's medical care. The right to access medical care freely and without fear must be vindicated by the law and enforced by the Garda. It is as simple as that. We also must ensure that all hospital staff are protected and allowed to do their jobs without interference or intimidation.

Since the passage of the 2018 Act, those seeking and providing abortion healthcare and the facilities in which they work have been subject to protest which aim to prevent access to or provision of reproductive healthcare. Such protests or religious displays outside healthcare settings distress and intimidate those accessing abortion healthcare and seek to create a chill effect on healthcare providers. It must be awful to walk past somebody who is creating that kind of scary chilling effect for people going to their job every day. Opponents of this Bill will claim that these protests are peaceful and an expression of religious conviction. Anyone who campaigned during the referendum in 2018 is aware of the graphic imagery, abusive language and vitriol that some anti-abortion activists are willing to deploy and it can be very traumatic. Known far-right activists, some of the people responsible for the riot on 23 November and the intimidation and harassment of refugees, also participate in these protests. They are not without risk.

This Bill is particularly important for rural GPs whose practice is often attached to their home. They are the medical practitioners most likely to be discouraged from providing their communities with abortion healthcare due to fear of protests. We know how patchy the availability of abortion is in rural areas. This is key legislation for ensuring equality of access across regions.

My colleagues and I will table amendments on Committee Stage to try to improve the Bill in some areas where we think it still needs a bit of work. In his reply, the Minister might clarify some of the points we raise. If he cannot reply today, perhaps he could reply in writing. On interpretation, are the definitions of "obstetrician", "gynaecologist", "medical practitioners" and "relevant healthcare providers" construed to include nurses, carers and other hospital staff such as porters and cleaners? I ask this because it is essential that they are also protected under this Bill.

On the warning system, I note the comments the Minister made on Report Stage in the Dáil about the appropriateness of proposing statutory regulation of Garda operations. However, we may need to reconsider that at this point. There must be a system for recordings of warnings if this legislation is to work effectively. If the Oireachtas decides that this is appropriate, the Garda will be legally bound to implement a recording system. I think the Minister mentioned a review. We have waited more than five years for this legislation and we probably need to get that now. The lack of a recording system for warnings is problematic and we need effective policing of these safe access zones and rigorous application of this legislation.

When having this debate, we must also look to the larger context. I welcome the review of the 2018 Act by Marie O'Shea who clearly identified we have a long way to go to ensure the mandate of free, safe and legal access is fulfilled.

One of these issues is access to abortion care in the case of a fatal anomaly. This week Deputy Bríd Smith raised the fact that recently a woman whose unborn baby was diagnosed with a fatal foetal anomaly was refused a termination at 22 weeks and she will be forced to travel to Liverpool to access abortion care. This is not a unique situation. Section 11 of the 2018 Act reflects the ghostly presence of the eighth amendment and continues the actively cruel practices to which women in the country were subjected for decades. This also need urgent amendment. There are many issues needing resolution, including full decriminalisation, the removal of the sexist and demeaning three-day wait period, expansion of telemedicine and better data collection on the experiences of the women accessing abortion care, particularly migrant, disabled, working class and Traveller women.

We need to address the abuse of the conscientious objection system. At the health committee's meeting with Marie O'Shea we heard horror stories of women being caught in fruitless cycles of referral, going from doctor to doctor with their time running out. It created enormous anxiety for these women. It fundamentally undermined their right to access healthcare in a dignified manner. Repeal of the eighth amendment in 2018 was won with a large majority. The campaign mobilised tens of thousands of activists who hit the streets and made the argument in the media and on the doorsteps. They had millions of conversations, some of which were very difficult. They won a mandate for real change and it is our job in the Oireachtas to deliver this change. Let us continue to build on this momentum. I warmly welcome the legislation and I thank the Minister for his work on it. The Civil Engagement Group looks forward to engaging with the Minister on Committee Stage.

I pay tribute to the work of the Minister in the area of women's health. His record and legacy when it leaves the Department will show that he has done more in this area than any other Minister since the foundation of the State. If we look at the issue of termination of pregnancy, one of the best ways to deal with it is through having proper sex education and access to contraception, and ensuring every baby is wanted, as many in the pro-life campaign would argue. The Minister has led the way in work on this.

I voted "Yes" in the referendum in 2018. I struggled with it like many Irish people. I was convinced by conversations I had with many women I know who shared their personal stories with me. Some of them had very difficult personal journeys. When they need to access healthcare it is essential that they are able to do so in a safe and uninhibited way. Any discussion comes between them and their medical professionals.

I want to address a general point on protests and freedom of expression. It is critical that we listen to alternative views. I disagree with those who opposed the repeal of the eighth amendment but those who have a view that abortion should be limited or restricted in particular ways, even though I disagree with many of their views, have a legitimate right to express these points of view. Those of us on the opposite side have a duty and obligation to listen to these points of view. In an increasingly polarised world it is more important than ever that we listen to alternative perspectives.

That said, when it comes to policy decisions, and when people wish to protest about a policy decision, there are certain places where it is appropriate to protest and there are places where it is inappropriate to protest. If someone wishes to protest about the health policies of the Government in any way the correct place to do so is outside the gates of Leinster House or outside the Department of Health. People can disagree as vociferously as they wish with the Minister and the Government's policies. The idea that there is an uninhibited right to freedom of expression and freedom to protest is not true. If someone disagrees with the Government's immigration policy there are correct places to protest but it is not outside the homes or temporary shelters of those who are seeking refuge in the country. It is no different for people who wish to protest about the policies of Israel; it is not correct to engage in anti-Semitic protests outside synagogues or places where Jewish people go together.

If we are to defend the right to freedom of expression and the right to freedom of protest it can only be done by ensuring there is a balance with the other rights individuals have. I will stand up in this House and strongly defend, even though I disagree with them on many occasions, the rights of Senators Mullen and Keogan to say whatever they wish to say, within reason. They can say it in this Chamber, they can say it outside of Leinster House and they can say it in other public fora. When it competes with ensuring an individual's right to access to healthcare, however, then protesting outside a hospital is not an appropriate place to do this. The Minister is very clear that the Bill does not inhibit somebody's right to oppose the Minister's policy or Government policy. It does not inhibit somebody from holding passionately a very strong position on abortion or any other healthcare issue. What it does do is ensure that expressing that right, which we should all respect, would only be done in suitable places. The Bill is balanced. It puts the necessary safeguards in place. I echo the comments of colleagues and I hope we can enact it as soon as possible.

I thank the Minister for bringing forward the legislation. He said he would, he has done so and here we are. He gave very strong assurances when discussing legislation tabled by Members of the House. He said repeatedly he would bring in this legislation. He has been here twice this week and I say well done and congratulations and I thank him very much.

Senator Malcolm Byrne has robbed all of my lines. The Minister has shown a consistency of support for women's healthcare and a dedication to making sure that women have access to a continuum of healthcare. I have spent all of my adult life attempting to have a child. People then challenge me when I stand in a pro-choice position. They ask me how I could do so because I know what it is like. The fact is that access to lawful healthcare, regardless of what people need, is a fundamental right for men and women. It is important that those who need to access termination and abortion services have the unfettered right to do so.

My notes were substantially about protests and the location of protests. It is fundamental that we listen to those with whom we disagree. Of course we do. I have great regard for Senator Mullen. He comes from a place of absolute faith conviction. While he and I disagree on a lot, I believe he does come from a place of absolute faith conviction, and so we will joust in the House. The suggestion that to fetter the right to protest at medical centres is a silencing of voices, or a silencing of freedom of expression, the right to protest or constitutional rights, is plainly false.

People who have something to protest about can write to us. God knows, we get enough emails. They can contact our constituency offices. They can contact our Dáil and Seanad offices. They can protest outside the gates of Leinster House. We have the barriers up today and we are ready for whatever the nature of the protest is beyond those barriers. People can protest here all of the time and we welcome them. Quite often protest has that strong voice of bringing change. There are many protests that we go out to en masse to support and to hear the lived experiences of people and bring this into our debates. If people are protesting outside a medical centre and saying prayers outside a medical centre they have only one purpose and that is to intimidate those who wish to access the services.

I travel past one medical service every Saturday and there is a protest outside of it, every Saturday. It is appalling for the women who need to go in there to get the services of that particular centre. I have gone to the National Maternity Hospital in Holles Street and needed to access the services there in the context of my own journey of fertility. I have seen the coffins and depictions of so-called aborted foetuses, and how horrific that is for women going in to access termination services but also for those going in grieving loss and perhaps about to come out with the remains of their pregnancy to bury it and face into a funeral. I have sat and spoken with women who have had both of those experiences and it is absolutely and utterly horrific. It shows a lack of any compassion and any empathy. Yes, a proportion of our people voted against repeal but we live in a democracy and their position does not give them a right to bully. It gives them a right to keep trying to raise it, as the repealers did for years. It gives them that right. However, it does not give them a right to challenge, silence, guilt and judge those who would try to attend. There is only one function, and the function is judgment. It is paternalistic and now well outdated. We are long since past the place where they know better than the woman who is choosing the service. I congratulate the Minister. I know they have all had a lot on their plate. I thank him for bringing this forward. The shame here is that it is needed at all. It should never have been needed at all but we have now recognised that it was, and it is. It is fine legislation and I look forward to supporting it all the way through Committee Stage.

I welcome the Minister. I was not intending to speak, but I felt it was important to put my support for this legislation on the record. It is welcome and I hope it can be progressed, as Senator Gavan has said, before Lent and before those protests ramp up once again. I commend my colleague Senator Gavan, Karen Sugrue and all of the Together for Safety group on their efforts in progressing safe access zones. As others have said, no woman should have to run the gauntlet of white coffins, crucifixes and protesters while they are trying to access healthcare. Likewise, no healthcare worker should feel intimidated for just going to work and doing their job carrying out medical procedures that are lawful in this State.

However, I take great offence to the charge made by some that dissent is somehow being silenced by this Bill, or that there is a general narrative out there that you cannot express dissent if you are anti-choice. It reminds me of those who scream the loudest about cancel culture, but are doing it from their columns in Sunday newspapers. They are doing it from their radio platforms and their TV shows. They are so-called cancelled columnists. Those who were saying that dissent is being shut down today, ironically, are elected, and that is perfectly fine in a democracy. They are elected on a platform that sets out they are anti-choice. They have been elected on that platform, and they are in here and have a platform to raise their concerns. They are not being silenced in any way, shape or form. The truth they cannot accept is that they are now in the minority. Those of us who for years fought to change positions in parties, or through referendums, know what it feels like to be in the minority. That is the reality. They are now in the minority and this Bill reflects that Ireland, and two thirds of Irish society supports women's right to choose, support women's bodily autonomy, and supports them being able to access the healthcare they deserve. It does balance that right to protest and assemble with those rights of women. It is important to say we know what these so-called protests are about. They are about the chilling factor. That is absolutely what they are about. I hope that once we get this legislation passed, more healthcare providers will feel comfortable to offer the services. It is completely wrong that there are women across this country, in particular in rural Ireland, who are being denied access to the healthcare they deserve because of the chilling factor of these protests.

As I have said, it is very welcome legislation. It is another reason the Seanad should be back as soon as possible doing its work, because we need to progress this legislation as soon as possible. It is long overdue and it is necessary. Until we do it there will be women today, tomorrow and next week running that gauntlet, trying to pass those white coffins while trying to access their basic human rights.

I do not need five minutes. I just wanted to lend my support to the Second Stage of this important legislation. Rolling this out is a critical component of a decision made democratically a few years ago. Some of the language we hear from the other side of the Chamber never ceases to amaze me. They speak of supremacy over minorities. That is not the case. This is legal healthcare and people have an entitlement to access it without intimidation, without the forces of control and shame that have been too powerful in this State for too long. I thank Together for Safety for all of their work, and I thank the Minister for bringing this important legislation to the House before Christmas. I look forward to its passage.

I thank colleagues for their contributions to this Second Stage debate. I am aware that this is an issue close to the hearts of Senators and the Seanad has played a leading in this through the cross-party sponsorship of a previous Bill. I also recognise the civil society work done to date on this by Together for Safety. It has played a really important role getting us to where we are today. I also recognise that there are diverse views on this issue and it is essential that we have an open debate, that we listen to each other, and respect each other's views. In July last year, I received Government approval to draft the legislation to ensure safe access to premises where termination services are provided. We have been working since then to bring forward the draft we have today.

The Bill will allow patients, service providers, healthcare staff and members of the public to enter and leave premises without fear of intimidation and harassment. It will also promote a culture of respect for the dignity and autonomy of individual decisions with regard to healthcare matters and will protect those from unsolicited influence. Officials from my Department have engaged extensively with the Office of the Attorney General and other relevant stakeholders in the course of putting this Bill together to ensure that all areas of the legislation have been considered carefully and in detail. As reflected by Senators in the debate we have just had, this is a complex area of law seeking to balance competing constitutional rights. We have rightly heard from contributors to this debate that it is vitally important women can access lawfully available healthcare services without fear, harassment or intimidation. My own long-standing position on this is clear.

However, it is equally important that the impact of the proposed legislation on the rights of those affected is proportionate to the objectives we are seeking to achieve. Freedom of peaceful assembly, freedom of association, freedom of expression and freedom of thought, conscience and religion are fundamental rights in a democratic society. Ireland has significant human rights commitments and obligations, both domestically through the Constitution, and internationally. Article 40.6.1° of Bunreacht na hÉireann provides that the State guarantees liberty for the exercise, subject to public order and morality, of the right of the citizens to express freely their convictions and opinions, as well as the right of citizens to assemble peaceably. Similar rights to freedom of peaceful assembly, to freedom of association, freedom of expression and freedom of thought, conscience and religion are protected in the European Convention on Human Rights, the Charter of Fundamental Rights of the European Union, the International Covenant on Civil and Political Rights and the Universal Declaration of Human Rights, a large copy of which hangs in my office.

These freedoms are subject to exceptions but, while that is so, the United Nations has specified that states should establish a positive presumption in favour of peaceful assembly. This means that there is a very delicate balance to be struck in devising the legislation we have before us. We are all elected representatives and, regardless of our political views or our views on any given policy, I know that every Member of this House and of Dáil Éireann believes passionately and forcefully in the right to protest, the right to assembly and all of the associated rights I have just listed. I say that as someone who has had protests outside his own house. We welcome and encourage protest and I am sure we have all been involved in protests outside Leinster House and in many other areas. We absolutely support and defend those rights. Therefore, when we bring in legislation that creates exemptions to those rights, such as this Bill, we do so in a very careful way. I believe this Bill has got the balance right. It acknowledges and promotes, on a proportionate basis, the human rights and constitutional rights involved. Critically, as many contributors have said today, it ensures safe access to legal healthcare services in our country. Ultimately, that is what this Bill is about. It is not intended as a general prohibition on expression, assembly or protest. It does not interfere with the right to advocate. That applies to both sides of the abortion debate.

Section 3 sets out the exemptions that apply with regard to prohibited conduct. The mechanism for the Garda warning also enhances legal certainty. There was a lot of debate on this in the Dáil and on Committee Stage and I have no doubt that we will have further discussion of it on Committee Stage in the Seanad. As discussed, on foot of Committee Stage discussions in the Dáil, we have added a review clause because this is unique legislation and we want to make sure we get it right. If it does not unfold as we want it to, a timely review will see if any changes are required.

I thank Senators for their very generous words on women's healthcare in Ireland. This is part of that. As has been alluded to, we are looking to provide proper world-class services right across the spectrum of care. Part of that relates to fertility. We have free contraception in place and we are expanding that provision year by year so that it will ultimately apply to all women. The feedback on this has been really positive. GPs and healthcare providers have said there has been a very large take-up among the eligible age cohorts. It is very interesting that GPs have said there has been an unintended benefit in that they are getting younger women into their clinics who would never normally have come in to talk to a GP because they are healthy. GPs are getting to talk to these women about their physical and mental health and their lifestyles. They have said this has been very positive.

After that, as Senators have alluded to, we have invested very heavily in the maternity strategy. Again, there has been a focus on choice for women. This includes birthing pools and midwifery-led care or community-based care as well as hospital-based care.

On termination services, we have had a modest increase in the number of GPs providing services. I believe, as do many Senators here, that this legislation will help by providing those GPs with additional safety and security. We saw really important progress in the last week in that five more maternity hospitals have now signed up. This means we are now at 17 of the 19. We are in very active discussions with the final two.

We have also been providing additional services in respect of fertility. We have launched IVF. When we get the Health (Assisted Human Reproduction) Bill through, we will be able to move to publicly provided IVF and extend it to donor-assisted IVF for both heterosexual and same-sex female couples. I have just come from a briefing with the advocacy groups on surrogacy and assisted human reproduction. We got the Bill through Cabinet two days ago. A vast amount of work was done to do that this year but I did commit to getting it over the line before Christmas. That has happened.

We are also investing in menopause services, endometriosis services, perinatal mental health teams, mental health services, eating disorder teams and a lot more. We are going to continue this through next year. We have had a two-year women's health action plan. It has gone really well. If every part of the health service responded and implemented things at the pace the women's health teams have, we would be in a fantastic place altogether. This is an important part of it. It is only one part but it is part of a spectrum of care.

We all know that Ireland has a dark history in respect of women's healthcare with regard to reproductive rights and more broadly. It is extraordinary that there has been a stigma around discussing menopause. It is also kind of extraordinary that we have not had specialist menopause and endometriosis services in our country. Anyway, we are putting all of that behind us. This is an important part of that. Our ambition is for Ireland to be seen as one of the most progressive countries in the world when it comes to modern women-centred healthcare with the voice of the patient, the woman, front and centre both in the provision of care and in determining where investment should go and what new services need to be provided. I thank colleagues for their contributions. I look forward to engaging again on Committee Stage, which I hope will be very soon.

I thank the Minister, Deputy Donnelly, for his unstinting and relentless work on women's health throughout the year. What he has managed with the legislation, even just this week, is quite incredible. I thank him and all of the team behind him, who I know are very supportive. It would be difficult to manage the Minister's legislative programme without their work. I add my voice to those expressing gratitude to Together for Safety, Karen Sugrue and her team, who have been relentless in keeping all of us honest as regards the work that needed to be done.