Following the enactment of the 2018 abortion Act, The Clinical Advisory Forum (CAF) was established within the HSE to “inform and enable the provision of a safe, high quality termination of pregnancy service.”

It is accountable to the HSE’s National Women and Infants Health Programme (NWIHP) and reports directly through its Chair, Dr Aoife Mullaly, to the NWIHP Programme Director.

I think it is safe to assume that the vast majority of people will have never even heard of this Forum despite the centrally important role it plays in how abortion ‘services’ are rolled out.

Essentially operating out of public sight, its whole purpose is to provide a method for formal clinical input into the “continued expansion of Termination of Pregnancy Services.”

This is part of the reason why I recently submitted a Parliamentary Question to the then Minister for Health Simon Harris, asking him to clarify the membership and terms of reference of the Clinical Advisory Forum and the number of times the Forum has met.

The reply I received today from the Director of the HSE’s National Women and Infants Health Programme has confirmed to me that the HSE are simply not interested in hearing from any organisation which might want to question the ongoing ‘expansion’ of abortion provision.

In fact, we now know from my PQ Reply that the Forum is comprised of “a number of special interests groups including the Institute of Obstetricians and Gynaecologists, the National Women’s Council and My Options – Crisis Pregnancy.”

The PQ Reply does speak about how the Forum will “develop consensus recommendations on provision of ToP services and emerging issues based on all available sources of evidence.”

But no one with even the slightest degree of familiarity with Oireachtas debates on abortion will give that statement any credence whatsoever.

When I and a small number of my colleagues tried to introduce evidence around foetal pain during the 2018 debates, we were essentially dismissed and accused of trying to overly emotionalise the debate.

This was despite the fact that there existed a significant body of embryological research demonstrating that unborn children could feel pain.

So, when the PQ Reply speaks of how the Forum’s recommendations will “inform the development and/or revision of clinical guidelines and the Model of Care for Termination of Pregnancy Services” you will have to excuse me if I take that with more than a pinch of salt.

The reality is, that the HSE are not looking for critical voices on abortion. They have established a talking shop where ‘consensus’ is never going to be difficult to achieve because the members are essentially all of the same mind.

There is one direction of travel and that is further and further expansion.

To date the Forum has met twice since it was established, once in February and once in May of this year. We have yet to establish if the Forum has engaged with the death of the unborn child in Holles Street in May 2019 following a misdiagnosis of Edwards Syndrome.

Will that child’s tragic death lead to a “revision of clinical guidelines”?  Nothing we have experienced to date suggests that it will.

The Report published last week outlining the 6666 deaths that had taken place in 2019 was a significant, if heart-breaking event. It generated mild levels of attention from the media.

The ‘problem’ is that Reports of this kind only take place once a year. I would suggest that while we continue to shine a light on important Reports of this kind, we also take the time to see how the abortion infrastructure in this state is being expanded on a daily basis.

That is another reason I submitted the PQ and one of the main reasons why I will continue to do so.



Carol Nolan is an Independent TD for Laois / Offaly