Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I thank the Minister for his answers. With regard to the HPV vaccine, I welcome the fact that HIQA is due to report by the autumn. Some 30,000 boys will not be vaccinated this year, because of the loss. I could hazard a guess that it will probably be September 2019 before we seek to start vaccinating. Perhaps I am wrong; perhaps it will be six months earlier. While we are on a roll here and while we have managed to reverse from 50% or 51% up to 61%, there might be an opportunity to move things on a little faster.

Mr. O'Brien mentioned the ancillary or core recommendations that we would like to change. I remember a pie chart from the recommendations. The split was 44% to 56%. However, give or take, 50% of crisis pregnancies are due to no contraception and 50% are due to contraception failure. I fully support the position on accessibility to contraceptives to bring about a reduction of crisis pregnancies - I know the Vice Chairman shares my view in this regard. In the first instance, this should happen through sex education. Furthermore, adult contraception would seem like a good place to start.

I am conscious of the medical view on the vaginal mesh. It seems to be used to treat various conditions and there are various ways of going about it. This is relevant for the maternity strategy. To a great extent, incontinence, especially in women, was a taboo subject for years. It was seen as a side effect of having children. The thinking was that women would get over it and it was not spoken about. I maintain the lack of pre-natal and post-natal physiotherapy as well as the quick through-put of women through hospitals are relevant factors. A woman is seldom in hospital longer than three or four days after having a baby. Indeed, we hear of some people being out after three or four hours. I acknowledge the great work that public health nurses do but I have found that it tends to be focused more around the baby rather than the mother. It is a pity the Minister of State at the Department of Health, Deputy Daly, is missing. One of the primary reasons for admission to nursing homes is incontinence. When it is not dealt with at maternity level, it goes into later life for women and causes problems. Incontinence can lead to urinary tract infections and this outcome is a common cause of confusion and falls in older people.

All this feeds into neglect of our maternity services. There is a major lack of investment and neglect of women in this country. It is all linked and it has an effect on quality of life. I know the Minister for Health is worn out from listening to me talking about incontinence pads, but there is significant expense on people as a result of this. Furthermore, there is the green aspect of the disposal of same.

I welcome the increase in medical cards for children. I hope children are getting them easily. We need to ensure that, in cases where adults are diagnosed, we make it as easy as possible for applicants to fill in the form and get medical cards.