'There has always been the option of going to Britain with all our problems - from unmarried mothers to emigration.' The words are those of Professor Anthony Clare, medical director of St Patrick's Hospital in Dublin, and the interviewer in Radio 4's In the Psychiatrist's Chair .

Clare has been giving evidence to an all-party parliamentary committee holding public hearings on the Irish government's Green Paper on abortion.

Abortion is prohibited, but 5,000 Irish women a year travel to Britain to have them. That number is rising. It is this situation which the government has promised to address, either by holding a constitutional referendum on the issue, or by legislating to allow for abortion in strictly controlled circumstances.

Abortion has been a bitterly divisive issue in Irish politics for 20 years and, as Clare reminded the legislators, it would be extremely foolish to think that 'the steam has gone out of it'.

That is one reason why the government has gone to such pains to promote civilised debate. Nobody wants a repeat of the bitter divisions of l983, when a constitutional amendment pledging 'to protect the right to life of the unborn child' was put to referendum and carried by an overwhelming majority.

In 1992 the whole situation was once more thrown into confusion when the Supreme Court ruled that a teenage girl, pregnant as the result of rape, should be allowed to travel to Britain to have an abortion, because her threat of suicide constituted a serious risk to her life.

In theory, this decision meant that it should be possible to perform abortions in Irish hospitals, in similar circumstances. That hasn't happened. One eminent obstetrician told the all-party committee medical practice was unaffected by the ruling.

But the public hearings have shown how far the debate has moved, at least within the Irish medical profession. It is now generally accepted, even by doctors opposed to any relaxation in the law, that pregnancies are terminated in Irish hospitals when the mother is at risk.

A difficulty arises in deciding whether such cases constitute abortion or not. Professor John Bonnar, Chairman of the Institute of Obstetricians and Gynaecologists, argues the procedures involved, while destroying the foetus, are not abortions because this is not the primary, deliberate intention.

Some of his colleagues disagree. One obstetrician told the committee he believed an outright constitutional ban on abortion would lead, sooner or later, to a situation where a woman's life would be at risk and the doctor would have to decide whether or not to break the law.

There are other agonising choices facing doctors and patients. A leading paediatrician raised the question of how a doctor should advise a couple who have learnt that their baby may be born severely handicapped. He cited the incidence of cystic fibrosis in Ireland, which is the highest in the world. There are couples who have two or three children suffering this tragic condition. In other countries termination of a second pregnancy would be the norm but this is not possible in Ireland. Instead, the couple have to decide whether to go to Britain.

For most Irish women these arguments, while genuinely difficult, fail to address the real problem. The overwhelming majority of those who fly to Liverpool or London do so for more mundane reasons. Their method of contraception has failed, they lack social and emotional support, or cannot face bringing up a baby on their own.

The London-based British Pregnancy Advisory Service, used by many Irish women, has presented a submission urging the Irish government to provide abortion facilities in their own country. It says: 'The women who come to us are not amoral, feckless or degenerate. They are normal women who have considered their position carefully and know that they must live with the consequences.'

Many Irish women would like to see the government face this challenge. But they are not holding their breath.