Official Report: Minutes of Evidence

The Chairperson (Mr Givan): I formally welcome Ms Gráinne Teggart, Northern Ireland campaigner for Amnesty International UK to the meeting. As normal, this session will be recorded by Hansard and published in due course. I will hand over to you at this stage. If you will take us through your key issues, I am sure that members will have some questions.

Ms Gráinne Teggart (Amnesty International UK): Thank you, Chair. I will begin by thanking you and the Committee for the opportunity to present Amnesty International's evidence on Jim Wells's proposed amendment to restrict lawful abortions to NHS premises and to provide an additional option to existing legislation of up to 10 years' imprisonment. I will outline the key points from our submission, and I will then be happy to take any questions. If there are questions for which I do not have the information to hand, I will be happy to take note of them and revert to the Committee in writing.

We are deeply concerned by the proposal to introduce further barriers to women accessing abortion in an already highly restrictive environment where abortion is governed by outdated, gender-discriminatory legislation. We are further concerned that this is proposed in the context of the Department of Health's continuing failure to publish guidance for medical practitioners that is enabling and focused exclusively on health-care provision, so that it is fit to serve the needs of medical practitioners and, by extension, women.

Access to safe abortion is recognised as a human right under the international human rights framework. That is because women and girls have a legally recognised right to life, a right to health and a right to live free from violence, discrimination, torture and cruel, inhumane and degrading treatment. A total ban on abortion and other restrictions that do not, at a minimum, ensure access to abortion in cases where a woman or girl's life or physical or mental health is at risk, in cases of rape, sexual assault or incest and in cases of severe fetal impairment violate those rights.

Governments have an obligation to ensure access to abortion and to ensure that the right, where legal, is not theoretical but is practical and effective. Governments should not impose burdensome or discriminatory requirements on access to abortion, including but not limited to medically unnecessary restrictions to access. Where abortion is legal, Governments must create a regulatory and legal environment to ensure its accessibility.

As drafted, the proposed 10 years' imprisonment could apply to health professionals and women. What we have here is a proposal to amend laws to sentence women, doctors, midwives and nurses to imprisonment and/or to punish them via a fine. No United Nations or European human rights body has ever recommended that a state party restrict access to abortion. UN treaty bodies have consistently called on state parties to amend legislation criminalising abortion to withdraw punitive measures imposed on women who undergo abortion. Criminal penalties are also recognised by the European Court of Human Rights as impeding women's access to lawful abortion and post-abortion care. In places like Northern Ireland, where there are severely restrictive laws, medical providers and women are reluctant to deliver or to seek service and information where there is a threat of prosecution and imprisonment. The proposed amendment is therefore in direct contravention of human rights standards that protect the dignity, autonomy and rights of women.

The amendment seeks to structure the legal framework in a way that further limits a woman obtaining an abortion. Human rights standards are clear that access to abortion should not be hindered, that abortion should be accessible and of good quality and that states have a responsibility to eliminate, not introduce, barriers that prejudice access, including conditioning that access to hospital authorities. That is especially important in a context such as Northern Ireland, where, in addition to women's bodies being governed mainly by laws dating back to 1861, our medical practitioners have no guidance clarifying that law in practice. The most recent guidance from the Department of Health served only to reinforce a climate of fear and the threat of criminal sanction and has therefore contributed to limiting access to abortion.

We object to the criminalisation of women and medical professionals and the implications that that has for the provision of abortion services. The European Court of Human Rights has said that, where states allow abortion, they must ensure its access and not structure the legal framework in a way that limits the real possibilities of obtaining it. Health care and accompanying laws should be designed to improve health care, as outlined by the United Nations Committee on Economic, Social and Cultural Rights in its general comment 14.

The United Nations committee that oversees the implementation of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) has stated unequivocally in its guidelines on the implementation of convention provisions that:

and therefore are counter to the convention. Members will be aware that the UK is a state party to that convention. It is therefore incumbent on our Assembly and Executive to withdraw punitive measures against women who undergo abortion.

The Parliamentary Assembly of the Council of Europe has stated that the final decision on whether to have an abortion should be a matter for the woman concerned, who should have the means of exercising that right in an effective way.

Being able to make decisions about our health and reproductive life is a basic human right, yet all over the world, women, including women in Northern Ireland, are prevented from doing so. The reality is that women in Northern Ireland do not enjoy those rights fully. Women are denied access to abortion except in highly restricted circumstances where there is a threat to life or a long-term risk to the woman's physical and mental health. Even then, access is not guaranteed. No guidance means that no clear pathway into health care exists.

It is 2014, and we have women in Northern Ireland who have been raped, are victims of incest or whose pregnancy has lethal fetal abnormalities, yet they are unable to access abortion in Northern Ireland. That is unacceptable. Women finding themselves in the most distressing of circumstances should not have to undertake difficult, costly and traumatic steps to avail themselves of health-care services. That, of course, refers only to those who are lucky enough — I use that term loosely — to find the funds to access this service across the water.

In addition to that which has been outlined, I invite members to reflect on the World Health Organization's recommendations on the issue, which concur with human rights standards. In its 'Safe Abortion: Technical and Policy Guidance for Health Systems', the World Health Organization states:

The World Health Organization also comments on the negative effects of legislative restrictions on abortion, which is particularly relevant to limited environments such as Northern Ireland:

On behalf of Amnesty International, I strongly recommend that this Committee and/or the Assembly reject the amendment and act to remove existing barriers to abortion services, including publishing guidance and removing criminal penalties against women and medical practitioners. Given the chilling effect of criminalisation and its negative impact on women's rights, it is preferable that a state tackles gender inequality and regulates health care through means other than recourse to criminal law. Amnesty further recommends that the Assembly and Executive place a gender perspective at the centre of all legislation, policies and programmes affecting women's health and that they involve women in the planning, implementation and monitoring of such legislation, policies and programmes.

Thank you for listening. I am happy to take questions.

The Chairperson (Mr Givan): Thank you very much, Gráinne. I will ask a few questions, and then I will invite members to come in. Does Amnesty regard the amendment that was put out for consultation as changing the law on the grounds on which a termination is allowed in Northern Ireland?

Ms Teggart: I think the amendment as drafted — I appreciate that amendments can be further amended — seeks to provide an additional option to existing legislation of up to 10 years' imprisonment that could apply to women and health professionals.

The Chairperson (Mr Givan): You know that the grounds on which a termination is currently permissible concern the mother's physical life or long-term, permanent mental welfare. Do you regard the amendment, which was consulted on, as changing the grounds on which a termination may be granted in Northern Ireland?

Ms Teggart: As things sit, there are no restrictions on providers such as Marie Stopes carrying out lawful abortions. Their operations are up to the first nine weeks of pregnancy. This proposal would amend existing legislation to restrict that access to the NHS.

Amnesty rejects that, because at the minute we do not have a clear pathway for women across Northern Ireland into health care. If we do not have guidance for our medical practitioners and women clarifying exactly what the law is and which abortions are and are not lawful, that creates a situation where access has been and is being hindered.

The Chairperson (Mr Givan): OK. I would like a very clear answer, and you are getting there. Amnesty International does not believe that the medical reasons allowing a defence for taking the life of an unborn child are changed by the amendment; it is solely about whether it is accessed in the private sector or the public sector. That is Amnesty's position.

Ms Teggart: That is correct.

The Chairperson (Mr Givan): What is the opposition to allowing the Public Prosecution Service (PPS) to imprison someone for a lesser sentence of 10 years rather than for life? Why is Amnesty opposed to that?

Ms Teggart: We do not think that there should be any criminal sanction. We do not think that it is appropriate to deal with a health-care and women's rights issue primarily through criminal justice legislation and the criminal justice system here. We think it would be much more helpful and beneficial to women's rights if that was done via health-care policy and legislation. As things sit, for example, if a woman presents — actually, I think that I answered the question, unless you want me to expand.

The Chairperson (Mr Givan): Obviously, you are elaborating on Amnesty's view that it should not be a criminal offence at all, but currently it is, and currently the penalty is life imprisonment. Would Amnesty not take a more pragmatic view and say, "Well, you know what, rather than someone getting life imprisonment, it would be better if they got the option of 10 years"? To me, Amnesty might want to consider that; otherwise, we keep it at life.

Ms Teggart: I appreciate your point, but let me say unambiguously that we do not think that sentencing women for a maximum of 10 years is doing them any good service or justice on the issue. We would say that there should be no threat of sentencing to women who use these services; instead, we should have clarification of the law. We should also have human rights standards upheld. That means that minimum human rights standards dictate that access should be available on the current grounds but also where a woman has been a victim of sexual violence, rape or incest and where there are severe, lethal abnormalities to the fetus.

The Chairperson (Mr Givan): The Minister is obviously taking that consultation forward, and there is danger that this amendment will be debated in the other, broader consultation. That is why I am trying to keep exactly to what is before us, rather than elaborating on things that are not being consulted on.

Ms Teggart: May I add another point? Amnesty sees that there is a climate of fear and a real threat of criminal sanction both to our medical practitioners and women in Northern Ireland. As it stands and as we are having these discussions and this has been out for consultation, the amendment serves only to reinforce that climate of fear, which we do not think is helpful or human rights-compliant.

The Chairperson (Mr Givan): You said somewhere in your contribution that difficult and costly steps need to be taken. Do you think it is right that vulnerable women who meet the criteria to provide a defence on the basis of their physical life and mental welfare should have to pay for that in the private sector, rather than have it provided in the NHS?

Ms Teggart: I have two points to make in response to that. First, I will go back to a point that I have made: if we had adequate pathways into health care and guidance clarifying the law so that women in Northern Ireland could access lawful abortion, there would not be a need for providers such as Marie Stopes. The issue of cost brings it back to choice. There may be reasons why a woman chooses to opt for a service. At times, there is a rural/urban dimension to the issue. A woman might, for example, choose not to go to her GP, who could be a family friend; she may choose to go private and have the matter dealt with privately because that is a choice that she wants to make. Ultimately — you are absolutely right — Amnesty thinks this should be available via the NHS.

The Chairperson (Mr Givan): How many cases have you dealt with where that has been the case?

Ms Teggart: We are not service providers, but we have a report coming up on the issue. We know through anecdotal evidence that, in effect, we have a postcode lottery in Northern Ireland. A woman in the Belfast Trust area has much more chance of availing herself successfully of a lawful abortion than a woman in, for example, Fermanagh or south Tyrone.

The Chairperson (Mr Givan): Amnesty supports the extension of the 1967 Act to Northern Ireland. Is that correct?

Ms Teggart: That is incorrect. Amnesty does not endorse any particular piece of legislation, including the 1967 Act. We adhere to international human rights standards and what they say access should be. In Northern Ireland, health is devolved, and we make our own laws. We need to bring in laws that are human rights-compliant. We do not call for the extension of the 1967 Act, nor are we doing that through the My Body, My Rights campaign, which is under way at the moment.

The Chairperson (Mr Givan): When would Amnesty International believe that an abortion should not be carried out?

Ms Teggart: Again — I am sorry to be repetitive — where there is a risk to the life of the woman or to her physical or mental health, we think that it should be available, obviously. Ultimately, each state will decide on things like the time up until which a woman can access abortion. We do not get into restricting it to certain time limits. However, we are aware of and support the current time limit of 24 weeks, because science and medicine have shown that, after 24 weeks, the fetus can survive outside the womb. We would advocate for what is in the law here.

The Chairperson (Mr Givan): Amnesty's view is that the unborn child acquires that basic human right — the right to life — at 24 weeks.

Ms Teggart: No. Let me be clear and unambiguous about this: as things sit, no international human rights standards and no European court has ever extended the right to life prenatally. As things stand, there is no right to life for the fetus, and we adhere to those international human rights standards. We appreciate that, in the UK context, the limit is 24 weeks, and we are not going to call for anything further.

The Chairperson (Mr Givan): In your view, Amnesty's position, according to international human rights, is that the basic right to life is acquired only at birth.

Ms Teggart: The Universal Declaration of Human Rights and the human rights instruments that have stemmed from it state that all human beings are born free and equal. Those issues were tested in the European Court in 2007 in Tysiac vs Poland. I hope that I pronounced that right. At no point has the European Court, the European Commission or any international human rights treaty or body ever extended the right to life prenatally.

The Chairperson (Mr Givan): Is that Amnesty's position?

Ms Teggart: That is Amnesty's position as well.

Mr Dickson: Thank you for your comments, Gráinne. Given the conversation we have just had, do you consider Northern Ireland to be a hostile place for women in these matters, particularly on the issue of where they choose within the legal framework that we have? You said that you were not talking about going outside any legal framework or attempting to extend that legal framework. Do you think that Northern Ireland appears a hostile place to women who find themselves in need of the legal services that are available in Northern Ireland?

Ms Teggart: I suppose the short answer is yes. By way of elaboration, I have referred to the climate that we have at the minute, which is not enabling for women seeking to access lawful abortion services. It includes things like the lack of guidance from the Department, meaning that pathways into health care are not clear.

We recommend that a gender perspective be put at the centre of all legislation, policies and programmes, because we do not see women's rights being adequately reflected in either policy or laws as they stand in Northern Ireland. We think that women's rights have to be respected, and, when we talk about reproductive rights, we mean that women in Northern Ireland do not have access to those rights in the same way as other women do. So, yes, I think that there is a hostile environment for women in Northern Ireland, but, in fact, it is within the power of our Assembly and Executive to change that. One way to do so is to place that gender dimension or perspective at the centre of policies, laws and programmes.

Of course, the other way that we could do that is to look at the state responsibilities in Northern Ireland. International human rights standards are unambiguous about those, including sexual and reproductive rights and access to safe abortion. So, yes.

Mr Dickson: The amendment effectively restricts any choice to an NHS facility. I appreciate that this is probably not the business of this Committee, but, instead of having this restrictive amendment to the legislation, would it not be better if there were guidance and regulation — in this case, we are probably talking much more about regulation — through which the Department of Health could take on its responsibility and regulate all the private facilities or all the charitable facilities that are available?

Ms Teggart: Yes, absolutely. Amnesty has publicly stated and will continue to state that with each passing day the Department of Health is in breach of a court order. It should not have got to the point where health guidance for women needed to be the subject of a court order. However, we are where we are. The Department of Health can and should publish that guidance as a matter of urgency, and, without getting into the detail of the Department of Justice consultation, if and when the legislation has changed, the Department of Health should update its guidance to reflect changes in the law to ensure that every medical practitioner out there, from those on the front line like GPs to the specialists in our hospitals, are fully aware of the laws here on where and when women can access abortion.

Mr Dickson: What prospects do you think there are of the Department producing those guidelines, given the queue of matters like adoption and blood donation?

Ms Teggart: As things stand with the court order, someone will ultimately, either in court or otherwise, have to decide what constitutes a reasonable time in which to publish those guidelines. We wrote letters very recently to the Department of Health asking for clarification of when the guidance would be published, and the response was that the Minister was aware of the need to publish the guidance and would bring it back to the Executive before it is published. I am happy to be corrected on this, but I do not think that legally they have to do that, although I appreciate that, given the difficult subject matter, that may be the case. The Department of Health and our Assembly and Executive need to take their human rights responsibilities and women's rights responsibilities seriously. We need to understand the reasons why a woman might need abortion. Those needs are very complex, and, as things stand, we do not see our Assembly and Executive adequately considering them.

Mr Dickson: I appreciate that your organisation does not represent any particular provider in these circumstances. We have background information that Marie Stopes, for example, charges £450 for these services. That is a lot of money for someone who may not be able to pay and arguably should be able to avail herself of that free of charge through the NHS. However, there are people who are not only able to pay that amount but may even be in a position to pay more. A lot of concentration in this issue is directly pointed at that one provider, but there are other providers in Northern Ireland, including the Ulster Independent Clinic. Is that not true?

Ms Teggart: That may be the case; I cannot clarify that.

Mr Dickson: Most people would be availing themselves of insurance to gain medical assistance.

Ms Teggart: You are right to raise the socio-economic dimension to the issue in the context of the £450. You are also right that that is a lot of money, and there are plenty of women in Northern Ireland who may need access to abortion services who cannot afford that. That is why our Department of Health and the Assembly and Executive are failing women in Northern Ireland. Without getting too much into the Department of Justice consultation, although there is some overlap where there are, for example, lethal abnormalities with the fetus and they have to travel, it throws up a raft of issues, not least cost, bearing it in mind that it will be at the 20-week scan when a woman is given such unfortunate news, but also with the prospect of there being a lethal abnormality with a subsequent pregnancy. Those women cannot necessarily and automatically bring those fetuses back home for post-mortems, for example. There is a range of issues that demonstrate how our Department of Health and our Assembly and Executive fail women.

Mr Dickson: However, given that we are dealing only with the current law as it applies, does your organisation believe that the amendment restricts what is already a very restricted choice on the matter?

Ms Teggart: If the amendment were to be made, I think that the only thing that it would achieve would be a reinforcement of a climate of fear for our medical practitioners. In the ongoing absence of Department of Health guidance, that means that our practitioners would not have the security of providing lawful abortions, because they simply would not know what they were until they have it in black and white.

Mr Dickson: Is it the case that the woman who seeks that medical service is also putting herself at risk of being jailed?

Ms Teggart: Absolutely. I have to make it clear that that flies in the face of every international human rights standard going, which are very clear that health care, such as abortion, should not be subject to criminal sanction.

Mr Dickson: The very same medical professional who provides the current lawful service — I do not know about Marie Stopes — inside, for example, somewhere like the Ulster Independent Clinic can also provide that service and will also provide that service inside the NHS. Therefore, this would create a place where it is lawful for that individual to do it, as well as a place where it would be unlawful for that individual to conduct exactly the same procedure.

Ms Teggart: I think that it would further confuse an already confusing situation for practitioners and women, yes.

Mr A Maginness: Thank you very much, Gráinne; you are very welcome. The preamble to the Convention on the Rights of the Child says:

What is your comment on that?

Ms Teggart: My comment on that is that international human rights standards, including the Convention on the Rights of the Child, do not extend rights in such a way to trump the rights of the woman, who, obviously, already exists. Where this has been tested in court, no court has ever upheld the rights of the fetus, which legally do not exist, over the rights of the woman.

Mr A Maginness: This question is related in a sense. Under article 6(5) of the International Covenant on Civil and Political Rights and article 10 of the International Covenant on Economic, Social and Cultural Rights, there is a prohibition on the execution of a pregnant woman. What do you make of that? Why do you think that that is prohibited?

Ms Teggart: Obviously, the focus there is on preserving the life of the woman. Again, at the risk of sounding repetitive —

Mr A Maginness: Sorry. Is it an emphasis on the right to life of the woman, or is the emphasis not on the right of the child in the woman's womb?

Ms Teggart: There are no human rights standards that extend the right to life and the protection of the right to life prenatally.

Mr A Maginness: Are you saying that Amnesty would not support the right of the child in those circumstances and that a woman could be executed in those circumstances?

Ms Teggart: Again, at the risk of sounding repetitive, Amnesty International is very clear that it upholds international human rights standards, which clearly state that those rights to life do not extend prenatally. That includes those circumstances.

Mr A Maginness: What I am saying is that it is not just a straightforward matter of a woman's right and there is a grey area that could develop institutionally and in a jurisprudential sense. It is not just a straightforward right of the woman to an abortion; there are rights that the child in the womb could at least acquire. As an international humanitarian organisation, do you not allow for that?

Ms Teggart: The best answer I can give is that, where these issues have been raised through the European Court of Human Rights and other courts, those rights have not been upheld. Where these cases have been tested, an attempt to provide rights to the fetus has not been granted. As it stands, human rights standards and human rights rulings through the European Court and others have not been extended prenatally. That is what we as an organisation subscribe to.

Mr A Maginness: When did the European Court of Human Rights grant a woman the right to an abortion?

Ms Teggart: The right to an abortion is in several international human rights instruments, including —

Mr A Maginness: Sorry. When did the European Court of Human Rights say that a woman is entitled, under the convention, to an abortion as a legal right?

Ms Teggart: I will refer to one case, and, again, I will have to step back from giving the exact detail of this case. The 2007 case of Tysiac v Poland was a court case that, in the way that you have described, tested the extension of those rights to the foetus. In those circumstances, it upheld the right of the woman. Because I do not have that information in front of me, I am happy to revert to you in writing.

Mr A Maginness: I suggest to you that the European Court of Human Rights has never confirmed the right of a mother, of a woman, to abortion. The European Court has never come to that conclusion. Do you accept that as a statement of fact, or do you disagree with that? If you disagree with that, tell me.

Ms Teggart: I disagree with that on the basis of what I currently understand. I am happy to revert to you in writing when I have looked at the range of court cases that have been before the European Court. I should say that, with a focus on the European Court of Human Rights, we also need to keep a focus on conventions that the UK is a state party to. That includes CEDAW.

Mr A Maginness: I understand the argument that you have made about CEDAW — you have made it very robustly — but the reality is that CEDAW is not justiciable in this jurisdiction, whereas the European Convention on Human Rights is. If what is you say is correct — that there is a right to abortion — any woman from Northern Ireland could go to the European Court and demand that right, so you are wrong in relation to that. The European Court of Human Rights allows any state that is a signatory to the European Convention to legislate in relation to the prohibition of abortion. That is the legal position.

Ms Teggart: I will address two points there. Did you say that CEDAW does not apply in this jurisdiction?

Mr A Maginness: No, I said that it is not justiciable. You cannot go to the court and say that CEDAW says x, y and z, therefore please grant whatever relief I am seeking.

Ms Teggart: Where states, including regions like Northern Ireland, are outside human rights standards, including those contained in CEDAW, they can be and have been challenged, not here but in other jurisdictions, so there is a right to do that. On the wider matter of the European Court, as I said, to the best my knowledge, the European Court of Human Rights has never upheld the rights of the fetus or introduced the rights of the fetus over the woman. But —

Mr A Maginness: Sorry, Gráinne. I am not arguing that point. That might happen in the future, but it has not happened up to now. Throughout your submission to the Committee, you said that there was a right to abortion. I am saying to you that there is no justiciable right to abortion within the context and confines of the European Convention on Human Rights. The court has never acceded to that, and it allows a margin of appreciation to all the signatory countries or states in relation to the convention. That is fact.

Ms Teggart: I have heard the point that you have been making there, and apologies for misinterpreting that. I have heard it loud and clear there. It possibly came down to how I worded that in my introductory remarks. I should have separated what the European Court of Human Rights has said and what international human rights standards say.

Mr A Maginness: Can we take it, then, that there is a difference between what you term international standards on human rights and the European Court of Human Rights, which is directly applicable to our jurisdiction? Is there a difference?

Ms Teggart: International human rights standards apply here obviously through the conventions that we have, which the UK is state party to and has signed up to. In terms of the jurisprudence and the extension of the European Court in Northern Ireland, I take that point.

Mr A Maginness: I just reiterate the point that there is no conferring of a right to abortion by the European Convention, or, indeed, by any treaty of the European Union, which is quite separate from the European Convention. I make that point to you. In terms of the jurisprudence, there is no right.

Ms Teggart: But, where cases have been brought before the European Court of Human Rights and it has found violations of the right to health, the right to freedom from discrimination and so on, it has found in favour of women accessing abortion. I probably should have said that at the outset.

Mr A Maginness: That is in the context where abortion is permitted in a signatory state.

Ms Teggart: I did say in my opening remarks that, where abortion is legal, states have a responsibility to ensure access and that that access is of good quality.

Mr A Maginness: But any state or territory within a state that has the legal power can have a prohibition on abortion; is that not right?

Ms Teggart: I would need to look into the legalities of that a bit more.

Mr McGlone: Alban covered quite a bit of what I was going to raise. Gráinne, the wording of your document, at the top of page 5, bugs me:

What do you mean by "human rights standards"? My standards are certainly not akin to what is stated there. Do you mean —

Ms Teggart: Convention standards.

Mr McGlone: Human rights standards can be quite a different thing.

Ms Teggart: I am referring to human rights conventions.

Mr McGlone: I am glad you clarified that. Alban teased out the issues around that, so we do not need to go into that any further. Is your organisation in favour of abortion by demand?

Ms Teggart: Define "abortion on demand".

Mr McGlone: Sorry, just in any circumstance.

Ms Teggart: We are fully supportive of a woman accessing abortion services in a way that protects her human rights. We do not subscribe to the term "on demand". We ask that international human rights standards are upheld, which includes, at a minimum, where a woman has been a victim of sexual violence or there is a risk to her physical and mental health and so on.

Mr McGlone: So, if a woman asks, she can have an abortion, according to your organisation.

Ms Teggart: In any circumstance?

Mr McGlone: Yes.

Ms Teggart: The legal framework in Northern Ireland currently would not permit that.

Mr McGlone: Sorry, I am not asking about the legal framework. Does your organisation have a position in regard to a woman going in and saying, "I want an abortion"?

Ms Teggart: If I may, I will just refer to our policy and what it does and does not say. Amnesty's policy is very much focused on the decriminalisation of abortion. That refers to the removal of criminal penalties against women and medical practitioners.

Mr McGlone: That is not what I am asking. Does your organisation have a position on abortion by demand?

Ms Teggart: My difficulty in answering that question is that we do not accept the "on demand" terminology. We do not think that a woman will demand an abortion willy-nilly.

Mr McGlone: Let us say "abortion by request", if you want to go in that direction.

Ms Teggart: A woman should have access to abortion as dictated by international human rights standards, which I outlined. That is what we are supportive of.

Mr McGlone: That is a yes.

Ms Teggart: It is a yes.

Mr McGlone: OK. I am glad that we got there.

On a final point, I hear "human rights standards". In my mind, the pre-birth child has rights. I listened to what you said and looked at your document. Maybe deliberately or otherwise, there is no mention of the child or even a nod in that direction.

Ms Teggart: We in Amnesty come at it from the point of view of women's rights, because, as I said, as things stand in international convention and law, there are no rights that extend prenatally. What you are referring to there is that you believe that there should be rights for the fetus.

Mr McGlone: Ethically and morally, I do.

Ms Teggart: We, as Amnesty, do not treat this is as a moral or ideological issue; it is a health and human rights issue. We come at this from the point of view of the woman's rights. We do not adhere to the notion of extending those rights prenatally.

Mr McGlone: So, it is exclusively women's rights.

Ms Teggart: Exclusively the woman's rights.

Mr McGlone: So, to your mind, the pre-birth child has no rights.

Ms Teggart: Well, as things stand in international human rights standards, those rights are not there.

Mr Lynch: I have a quick point, Gráinne. At the outset, you said that you had deep concerns. Could you summarise them in relation to the amendment?

Ms Teggart: Our concern with it is the restriction to NHS facilities. We think that, given the very restrictive context that we are operating in in Northern Ireland in terms of legislation and practice, it is potentially damaging to women who will need these services. We do not see it as being medically necessary to restrict access to abortion to NHS premises. We think that the absence of guidance from the Health Department, which would and should provide clear pathways into health care for women here, has given rise to a need for alternative providers, including Marie Stopes.

Mr Douglas: Thank you for your presentation, Gráinne. You state in the paper that Amnesty:

Could you elaborate a wee bit on that?

Ms Teggart: Yes, I can explain that quite simply, although tell me if you want further detail. What we mean by "gender-discriminatory" is that these are services that will be needed only by women. Therefore, there is obviously a gender dimension to this. The laws against abortion in these circumstances are discriminatory against women.

Mr Douglas: You state:

You also referred to the case of Tysiac v Poland. Is your organisation saying clearly that we are infringing on those rights set down by the ECHR?

Ms Teggart: As things sit, Northern Ireland does not meet international human rights standards. We are in breach of conventions including CEDAW. We need our laws amended to enable women, at the very minimum, to be able to avail themselves of and access abortion services where there are lethal abnormalities with their foetus and where they have been a victim of sexual violence such as rape or incest. As things stand, we are in breach of convention rights, yes.

Mr Douglas: Are there any other examples of countries that have breached the rights of the ECHR?

Ms Teggart: There are many. I would be happy to provide further information on that in writing. Countries like El Salvador also have highly restrictive laws. We do not have to look too far. The South of Ireland also has laws that are gender-discriminatory, illegal in terms of international human rights standards, and do not uphold, protect and promote the rights of women.

Mr Douglas: If we, as an Assembly, implement this amendment, what would the penalties be? Are there examples of other countries that have been penalised?

Ms Teggart: If you are asking whether it could be challenged legally, the answer is yes. We are in breach of those standards. If this amendment were to be passed, it would be very damaging. It would affect greatly women availing themselves of those services. We, as Amnesty, have documented that, in countries like Nicaragua where abortion access is subject to criminal sanction, medical practitioners are often reluctant to provide either information or these services for fear or threat of imprisonment. We have seen that the world over.

Mr Douglas: I know that you responded to Patsy along these lines, but I was recently in discussion with two Christians. They were talking about when a foetus becomes a baby. One of them said that it is at the moment of conception, and the other one said that it is when the heartbeat starts. Are you saying that the baby is not a baby until it is actually born? Is that your interpretation?

Ms Teggart: When we talk about when life begins, it takes us into the religious and moral dimension. We, as a human rights organisation, do not, therefore, take a position on when life begins. What we do is subscribe to the human rights framework and uphold the emerging legal consensus that human rights are applied from the point of birth.

Mr Poots: Thank you, Gráinne. Gráinne, you indicate that your view of human rights is that the unborn child has no rights until it is actually born. So, in theory, abortion at 24 weeks could be abortion at 26 weeks or 28 weeks, because there are no rights.

Ms Teggart: We recognise that, where there is a risk to a woman's life, for example, that risk to life could happen at any point during pregnancy. You are right that that could happen beyond 24 weeks. We think that, in those circumstances, the duty is on the state and, therefore, medical providers to uphold the life and the rights of the woman. They should take steps to protect that life, which already exists.

Mr Poots: That is the position of quite a lot of us. The protection of the life of the woman in the first instance is the priority. However, there have been seven million cases of abortion in the United Kingdom over the last 45 years. Quite clearly, there were not seven million women whose lives were at risk over that period. So, we should stick to the questions that are asked. Under your reading of the rights of the child, in theory, abortion can go well beyond 24 weeks in circumstances that are not related to protecting the life of the woman.

Ms Teggart: Apologies if I am sounding repetitive after answering Sammy's question, but the rights of the child apply from the point of birth.

Mr Poots: So, in theory, Amnesty International could have abortion taking place until 37 or 38 weeks.

Ms Teggart: Again, it is quite complex. You present it as straightforward that abortion could be granted at 36 weeks. There would be circumstances that would give rise to a woman needing or requiring access to abortion at 36 weeks. Forgive me for using these terms, but you are presenting it as black and white that, up to 36 weeks, a woman could access abortion. I find it highly unlikely that a woman would be asking for an abortion at 36 weeks if there were not those other considerations. It would not be a flippant decision such as, "I am 36 weeks' pregnant. I do not want this pregnancy. Therefore, I want a termination". It is not quite that straightforward.

Mr Poots: It is much less likely as a pregnancy goes on; I do accept that.

You quoted a number of grounds for abortion, but you, as Amnesty International, are not restricting it to that in reality. If a pregnancy is unwanted because, for example, the woman who falls pregnant is a student and her final exams are coming up, or the woman is in a marriage, has had a family, and falls pregnant later, you would view it as entirely reasonable to have an abortion.

Ms Teggart: This might not be particularly helpful regarding that question, but Amnesty policy, as it is currently drafted, refers specifically to decriminalisation of abortion. What we, as an organisation, concern ourselves with is the removal of criminal penalties against women and practitioners. So, we uphold the rights of the woman first and foremost. We think that those rights should be respected first and foremost. However, as an organisation, our focus is on decriminalisation. It is also on ensuring that minimum human rights standards are met, which, as things sit in Northern Ireland, are not being met.

Mr Poots: So, essentially, Amnesty's view is that a woman's reproductive rights will always trump the rights of an unborn child.

Ms Teggart: I think that I have been very clear on this. Reproductive rights are human rights. They are women's rights in these circumstances when we talk about access to abortion. That is what Amnesty upholds.

Mr Poots: Yes, but the reproductive rights will always trump the rights of the unborn child.

Ms Teggart: That is not just —

Mr Poots: You are saying that the unborn child or foetus, as you describe it, does not have a right until it is born and you are saying that a woman has reproductive rights, so I am taking it very clearly from what you say that the reproductive rights of the woman will always trump the rights of the unborn child.

Ms Teggart: Yes, I think that I have stated that reproductive rights are women's rights and that it is her rights that should be upheld. I have to stress that that is not just an Amnesty International position; it is an international human rights standard through the convention rights that it recognises also. Where these cases have been presented to courts, including the Poland case, the European Court of Human Rights has never extended these rights prenatally. It is not just Amnesty that is saying this; it is not just our position. We, as an organisation, work to the human rights framework.

Mr Poots: So, you are saying that Amnesty International could live with considerably more lax abortion laws than the 1967 Act, in theory.

Ms Teggart: As things stand, without getting into a discussion around the 1967 Act — it in itself is not fully human rights-compliant — we do not endorse any specific piece of legislation. What we endorse are women's rights and human rights standards.

Mr Poots: Do you accept that the Health Department has brought forward guidelines twice and that those have been overturned in court twice?

Ms Teggart: The last guidelines that were issued were less helpful than previous iterations, including the 2009 ones. The most recent, which have just been published in Northern Ireland for consultation, did nothing to put the focus on health care and did nothing to put the focus on women's reproductive rights. It is a very legalistic document and very heavy on the threat of criminal sanction. In those circumstances, those guidelines are not helpful to medical practitioners or women here.

You are right in the sense that, yes, what Amnesty understands is that the Health Department has heard the resounding rejection of those guidelines and we await publication of ones that are enabling for women and medical practitioners.

Mr Poots: You would accept that the issue of abortion is controversial.

Ms Teggart: Absolutely. Let me be very clear: we appreciate as an organisation that this is a very difficult issue and that there are strongly held views at either end of the spectrum. We appreciate that it is a difficult issue for our legislature to grapple with. However, we point it to the various conventions and recommend taking the steer from them as to what should be in guidance.

Mr Poots: Consequently, it has to be an issue that goes to the Northern Ireland Executive and cannot be a decision taken by the Health Minister in that circumstance.

Ms Teggart: I know that previously —

Mr Poots: That goes back to the 1998 Act.

Ms Teggart: Others have stated that this issue would be brought back, and recent correspondence from the Health Department stated that, once the Health Minister, Jim Wells MLA, has considered the current draft of guidance that is before him, he will bring it back to the Executive, who will then agree to publication.

Mr Frew: I want to tease out some of the questions and answers with regards to the rights issues for the baby or the foetus, depending on how you describe the human life that is within the womb. You have been asked this, and again, this is a very sensitive and difficult issue, so we can understand why we would all struggle to answer and even to ask question on this. You keep referring to the human rights in that there are no rights for the fetus and rights really only begin once you are born. Does Amnesty International think that there should be rights for the unborn?

Ms Teggart: No. We adhere to what the conventions state. As a human rights organisation, that is where we take our lead. They do not extend those rights prenatally, so neither do we.

Mr Frew: It is not that they are against human rights for the unborn; it is just that they are mute on them. Do you agree?

Ms Teggart: No. Amnesty as an organisation considers the human rights dimension to this and the focus to be on the rights of the woman. We do not consider human rights to apply pre-birth. Again, I have to stress that this is not just an Amnesty International position; this is what conventions and other rulings have stated. That is where we as an organisation are on that matter.

Mr Frew: Is there even a debate happening within Amnesty International about campaigning for a change in human rights on this?

Ms Teggart: No, because conventions have not changed. Conventions uphold the rights of the woman.

Mr Frew: Does the organisation not think that it should or could campaign for the human rights of the unborn?

Ms Teggart: No. I appreciate that, for this debate, there are those who hold the view that human rights should extend to the rights of the unborn. It goes back to what you said, Paul, about the issue being very difficult and emotive. However, I must stress that, while abortion is a very difficult subject for us to grapple with, it is not half as difficult as it is for women in circumstances in which they are faced with the prospect of needing or requiring an abortion. There is a host of reasons and circumstances that give rise to a woman needing this. Therefore, while we can talk and have emotive discussions and debates about the rights of the unborn, they should never trump and have never, when tested in court, trumped the rights of the woman. It is the woman who is pregnant, and it is the woman who is faced with going through with the termination of a pregnancy for medical reasons or any other reason.

Mr Frew: Has there been any case throughout the history of a human life in which a person has been wronged, and Amnesty International stepped in and supported and campaigned for the individual. I will expand on that. You mentioned the woman who was, unfortunately, raped. Say something like that happened and she chose to keep the baby if she happened to fall pregnant, that is a life, and we have heard from people whose mother was a rape victim. That child growing up has nothing to do with the incident — that crime of rape. Even with the fallout, that human being will not experience anything around the incident, yet that human being's life could have been terminated if Amnesty International and its belief structures had had their way.

Ms Teggart: In those circumstances, Amnesty says that the decision on whether to carry on with a pregnancy that is the result of rape must rest solely with the woman herself. Should a woman choose to continue with a forced pregnancy if it is the result of rape, of course we absolutely think that that woman should be supported not only medically but emotionally, because she has been doubly traumatised. Not only has she had her body violated in the most violent way but she is faced with continuing with a pregnancy that she had not planned for and that has been forced on her. The physical and mental harm that women and girls face when they are forced to continue with a pregnancy that is the result of rape or other forms of sexual crime is well documented. To go back to the human rights standards, the minimum human rights standards are clear that women should have access to abortion in those circumstances.

The Chairperson (Mr Givan): Sorry to intervene: what about women who are forced to have an abortion by men?

Ms Teggart: Amnesty works on that issue globally. In places like China, where there is the unofficial enforcement of the one-child policy and there are forced abortions, Amnesty has been very vocal, because the decision on whether to have an abortion should always rest with the woman. When that is forced, either by a spouse, a man or a government, we absolutely object to it.

The Chairperson (Mr Givan): Surely the decriminalisation focus of Amnesty would only encourage men to use that more frequently when there is such a disincentive? As it is a criminal offence, women are being protected by the law from forced abortion, which, as you say, is a real issue not just in China but across the world.

Ms Teggart: I do not accept that. When we refer to decriminalisation, that is the removal of criminal penalties against women and medical providers. So I do not accept that point.

The Chairperson (Mr Givan): I am sorry. I know that we have strayed way off the amendment.

Mr Frew: I know that we have. I will get back to the amendment. Do we need private companies offering and administering abortions? Have you any concerns about registration, safety aspects, monitoring and the standards of private companies offering and administering abortions?

Ms Teggart: I do not. I think that women should be able to access abortion services in Northern Ireland via the NHS. The situation that we have of there being no guidance is enabling that provision, which has given rise to the need for private providers. However, it will always come back to the issue of choice. There may be reasons why a woman will choose to go to a private provider. As an organisation, we have not heard anything that would give rise to our having concerns about the provision of that care. In fact, as far as I am aware — I am happy to be corrected — Marie Stopes in Northern Ireland entered into voluntary regulation. Under the law, it did not have to be regulated, but it did so to have openness and transparency about its service provision. Nothing has arisen that has given me cause for concern. Ideally, women should have access through the National Health Service, because they are paying for that service to be upheld but are not accessing services here in a way that their counterparts are able to. In the absence of that and in the absence of guidance from the Health Department and their taking that necessary action, women will need and will continue to need these services.

Mr Frew: I do not even like talking in this way, but do you have a financial cost for administering an abortion?

Ms Teggart: I do not like to personalise the issue, but one case that has been to the forefront of all our minds in recent months, I am sure, is Sarah Ewart. In other cases like that, when women are given the news at 20 weeks that there is a lethal abnormality and that they have to pay for those services, it is anything up to £2,100, which is an extreme amount of money to which, I am sure that we will all agree, not every women will have ready access. That reinforces the point of why women need such access here. Amnesty sees that as a further infringement of that woman's rights, because it throws up a socio-economic dimension and socio-economic issues. Not every woman can afford to travel across the water to avail herself of services that her counterparts are taking for granted. In those circumstances, we are failing those women today.

Mr Frew: Does that figure include the cost of travel and accommodation? Do you know specifically how much it costs to administer an abortion? If we take away all the costs of travel and charges, is there a cost to administer an abortion? Does a sum of money need to be paid before anybody makes a profit, anybody gets to travel or anybody books an appointment?

Ms Teggart: I do not have those figures to hand, but my understanding is that it can range from £400 up to £2,000. The issues that that presents go back to what we discussed about the restrictions that that will put on enabling women to access that service provision. On profit, I should say that we are aware of service providers who waive those fees at times, because women find themselves in such desperate situations. We are also aware that organisations like Marie Stopes are not private enterprises but social enterprises, so those fees go to their work on reproductive rights in developing countries.

The Chairperson (Mr Givan): You referred to the regulation of private industry and said that private companies can be regulated voluntarily. What is the nature of the regulation.

Ms Teggart: I raised that point in the context of Paul having asked whether we had concerns about private providers with reference to Marie Stopes in Northern Ireland. I made the point that we did not have information that had given us cause for concern. Amnesty does not get into the debate on private health care.

The Chairperson (Mr Givan): You did get into the debate because you said that Marie Stopes voluntarily went into regulation. What regulation of Marie Stopes actually takes place?

Ms Teggart: I would need to see the extent of what the regulation looks like, but I understand that it falls under the Regulation and Quality Improvement Authority (RQIA), which looks at doctors who provide that provision. That is the situation as far as I understand it. I did not get into the debate on private health care and the rights and wrongs of that. I made that point in the context of whether we had concerns over what provision was available. I made the point that we did not have any information that would give rise to us having those concerns.

The Chairperson (Mr Givan): You talked about social enterprise and private enterprise. Without going into specific companies, is there any concern on Amnesty's part that there is a conflict of interest in any financial transaction that deals with a life-and-death decision, be that from a social economy-type model or a profiteering-type model?

Ms Teggart: Amnesty's position is that these services should be available to women here via the NHS. It so happens that the situation in Northern Ireland at the minute is that there is no automatic access to lawful abortions because there is a climate of fear due to the guidance from the Department of Health.

The Chairperson (Mr Givan): So the private sector should be allowed somehow to circumvent the law. You are saying that we have this scenario in Northern Ireland because of the law preventing the NHS —

Ms Teggart: No. I am not a spokesperson for any clinic, nor do I want to get into a situation in which I am doing that. All clinics here have to operate within the law, regardless of whether they are private or at the Royal.

The Chairperson (Mr Givan): This probably gets to the heart of what the amendment is about: how do you ensure that criminal law — you clearly disagree that it is a criminal law matter, but it is — is upheld in Northern Ireland in a way that you can be satisfied, through proper regulation and accountability, that it is being enforced, other than saying, "They said they obey the law, so we'll take their word for it"?

Ms Teggart: It may not be helpful with the question that you have just posed, but Amnesty's concern is about the rights of women in accessing these services. It is not for Amnesty to dictate how medical care providers should demonstrate that they are within the law. To be frank, that is a matter for the Assembly, the Executive and possibly but not necessarily others, but it is not a matter for Amnesty. Our concern is women's rights and how they are upheld. I am saying that the right to private provision here and access to the NHS is not protected in law and is not automatic because of the vacuum and the absence of guidance.

The Chairperson (Mr Givan): There are no more questions. Gráinne, thank you very much for coming to the Committee meeting. It is much appreciated.