Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I knowledge and welcome this plan and the work that has gone into it. The three guiding words as set out in this plan are "listen", "invest" and "deliver". To listen is vitally important. A great shame of this country in its 100 years has been the fact it did not listen to women on many issues, not least on health. We do not need to go back over the whole list now. There has never really been an issue with the amount of money invested in health but with where it has actually been directed. A definite decision has been made here to direct it to areas that for too long have gone unnoticed or ignored at the very back of the queue, if they were ever even in the queue at all. Delivery is the test of any plan and it will be the test of this one.

A deliberate decision has been made regarding the €31 million in this plan. The Government could have put €31 million into any one of these areas and perhaps bring them on further. A deliberate decision has been made to get started or maybe progress things from a very small base, however, across a number of different areas such as endometriosis, maternal healthcare and sexual and reproductive health. I think that is the right way to go as long as that investment is continued and increased.

More than 100,000 women are diagnosed with endometriosis in this country but there is a nine-year waiting time for diagnosis for many cases. Many women are still undiagnosed, so a focus on endometriosis in such a way is required. I would, however, like this to be the first step towards looking at developing a national strategy for endometriosis such as exists in France and Australia. The Minister could work on that with the Endometriosis Association of Ireland, which has done some really good work on it.

The Minister has done work on care in terms of the menopause. Sinn Féin produced a policy paper on this within the past week. This is good progress because, again, this is another area that for too long has been ignored. Women have had the impacts of menopause ignored by healthcare professionals. They have been unable talk about it with their family members and, in many cases, their support networks. That is changing and we need the clinical back-up for that. The opening of three clinics is welcome.

There are a number of aspects to the plan in terms of breast cancer and HPV vaccine catch-up. Much of that is actually catching up on massive delays that occurred over the course of Covid-19. We need to have a whole other debate about undiagnosed illnesses and conditions. This action plan is not going to deal with that and I do not think it does, but I am just careful about putting it in.

I welcome free contraception for women aged 17 to 25. That is quite radical and very progressive but, again, contraception should not just be a woman's responsibility and we cannot let men off either. I understand putting in the provision in terms of the consequences of contraception all being borne by women. There also needs to be proper messaging in terms of the responsibility for men.

Rolling out period poverty initiatives across the local authorities is welcome. I acknowledge the work of Senator Moynihan in that regard. She did much work in terms of getting it on the agenda here and it has been taken up by Government. In terms of delivery, however, it will need to get from the local authorities to the people who need it. I would like to see the detail of how the delivery of that is going to happen. It is a very real issue.

The Minister was unable to attend the debate last week on the Health (Assisted Human Reproduction) Bill 2022. I know he would have liked to have been there because it is a very long, detailed and important Bill. The move towards publicly funded fertility treatment is something that needs to be expedited as quickly as possible. We all know it is a difficult issue with technical elements to it and all the rest. Time is of the essence in terms of fertility treatment, however. At the moment, it is only open to people who can afford it. We do not need to go through the whole list of factors that are affecting people in this country, from the cost of living and energy bills to mortgages and rents and everything else. Many people just cannot afford fertility treatment in any way, shape or form. That is something that needs to be expedited.

I tabled a parliamentary question on the safe access zones Bill, which was going to be taken this morning but we ran out of time. There is a cross-party Opposition Bill in the Seanad. I ask the Minister to progress it and not wait until the back end of 2022. I believe it is something the Minister wants to see brought in. I believe his bona fides on it but he has to prove it. A good Bill is there, which we could progress and get through.

As with any plan, the Minister has set a menu for himself and we will all be able to look at it over the coming months and years and hold him to account. That is our job. Again, this is not suite of measures that will resolve any of these issues in 2022 or, indeed, in 2023 and 2024. We will need to build investment in it. In the areas of endometriosis and the menopause particularly, it is very welcome to see a consistent light being shone and investment being made. It is to be hoped we will see the delivery of that.

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