Dáil debates

Thursday, 31 March 2022

Women's Health Action Plan: Statements

 

1:45 pm

Photo of Emer HigginsEmer Higgins (Dublin Mid West, Fine Gael) | Oireachtas source

I welcome the publication of the women’s health action plan. Its publication speaks to the tide change that is happening in the area of women’s health. It is something I very much support. Women’s health goes far beyond just family planning.

I am glad to see this action plan recognising the many facets and areas of women’s health that need and deserve attention. We have a very long way to go in ending the health-based discrimination women face. It can be very difficult for women to get the treatment they need. There are countless stories of women’s health issues being belittled, downplayed or even denied by health professionals and society at large. This action plan goes a long way to tackling the stigmas and creating access to research and treatment that will have a real and genuine impact.

I want to take time to highlight some of the key elements of the plan and what will change in 2022: €9 million to expand free contraception to women aged 17 to 25; 24 additional lactation consultants nationally; nine specialist eating disorder teams operating nationally; local authority period poverty mitigation measures; 20 see-and-treat gynaecology clinics; six regional fertility hubs; four specialist menopause clinics; the expansion of specialist services and out-of-hours care for paediatric gynaecology; the first GP lead for women’s health; the expansion of endometriosis services in counties Dublin and Cork; and a maternity bereavement experience survey, which is the first of its kind. These are all very welcome initiatives and they span the gamut of women’s health from maternal health and sexual and reproductive health to gynaecological and menstrual health, as well as wider physical and mental health.

In recent years, we have delivered significant improvements in our country's approach to women's healthcare. The repeal of the eighth amendment, for example, was a momentous achievement but, unfortunately, the legislation is not providing the access so many of us hoped it would. I know this action plan commits to progressing the review of the operation of the legislation, and that is so important. I am disappointed that improving access to and safety of terminations in Ireland and the provision of safe access zones do not feature more prominently in the action plan. I suspect this is because the review into the legislation is ongoing and actions will be based on that review. I hope the review results in an improved service.

Despite the pandemic, almost 200 women and girls travelled to Britain for an abortion last year, and one of every three women who did so was seeking a termination due to a fatal foetal anomaly. As I have said previously in the House, when Ireland voted overwhelmingly to repeal the eighth amendment, that is not what we expected or asked for. There remain counties with no abortion services and part of the reservation for many GPs may come from not wanting to attract protests or intimidation from anti-choice groups. I have previously raised the issue of safe access zones and I again call on the Minister to enact legislation quickly that will protect women, couples and healthcare professionals from these cruel acts of intimidation. Not only are protests happening regularly outside GP clinics and hospitals that provide abortion services but we are now also seeing a new phenomenon, namely, anti-abortion advertising outside these healthcare settings. It is important that a ban on such advertisements be included in our safe access zone legislation.

The expansion of endometriosis services in Dublin and Cork is welcome. This has been a really underserviced area. It can be very difficult for women to get a diagnosis. There are waiting lists for women currently in the process and there have been missed opportunities for diagnosis for women who have come forward with symptoms in years gone by. As recently as ten years ago, there was not the same level of awareness or investment that exists now. I have much concern for the many women who will have seen their doctor years ago regarding symptoms of endometriosis. They may have been advised they were likely to have endometriosis but that the diagnostic procedure would be painful and complicated and that, even if they did get a diagnosis, at the time there was not much that could be done or offered as treatment. Many women, therefore, did not go ahead with a diagnosis and have had to learn coping mechanisms.

In the meantime, however, there have since been substantial advances in technology, medicine, treatment and diagnosis and it is important we do not forget those women who gave up on a diagnosis long ago. Whether through an information campaign or direct GP outreach, it is important that all women suffering from endometriosis get the support they need. As we know, endometriosis can lead to fertility challenges. Sadly, I have heard reports of fertility clinics suspecting that a woman has endometriosis but choosing not to raise their suspicions with the woman in case she decides not to go ahead with fertility treatment if she knows it may have a lower chance of success. Those kinds of reports, if true, emphasise the need to regulate the fertility industry. This should be an important part of the improved model of care for infertility. I acknowledge it is an issue we discussed in the House last week. Ensuring a woman’s best interest is at the heart of healthcare is the only way forward.

Support for women experiencing menopause is another area I have been speaking about regularly in the Dáil. In 2019, the women's health task force recommended that we improve supports for women experiencing menopause. Last year, the country's first specialist menopause clinic was established in Dublin, which is very welcome. I welcome also the Minister's confirmation that the three additional menopause clinics that were promised will be delivered this year. Many women have contacted me to raise the issue of shortages in the supply of hormone replacement therapy, HRT, patches and gels and the inability to access them, an issue I raised recently in a parliamentary question. I was glad to learn the Health Protection Regulatory Authority, HPRA, has had regular and ongoing engagement with suppliers in this regard and they are collaborating to improve supply. Finally in this context, I welcome the creation of a group to examine how we can better support Civil Service employees who are going through menopause. I hope the group will examine the international experience and the recently introduced menopause supports for the staff of London’s City Hall.

It is important these kinds of working groups be established not just for the public sector but within private businesses as well. The Menopause Hub has found 22% of women experiencing moderate to severe menopause symptoms have missed three or more days of work and 85% felt they could not tell their employer the real reason for that time off work. Strikingly, almost half of these women have considered giving up work because their symptoms are so severe. It is sobering to hear that in 2022, many women going through menopause feel they may have to give up on their career. Some organisations are beginning to recognise the challenges of menopause for women and doing more to educate their managers and broader workforce. It would be great to see more employers design organisational policies on menopause as well as delivering menopause training for managers and HR staff to increase awareness of these issues in the workplace.

New Zealand is an example of a country with a progressive approach to women's health. Its approach to miscarriage, in particular, is one I would like to be replicated in Ireland. A number of my party colleagues, including Deputy Carroll MacNeill and Senator Seery Kearney, and I have been advocating for statutory miscarriage leave to be introduced to provide women with the necessary support in the event of early pregnancy loss. Sadly, one in every five pregnancies is lost in the early stages. The sadness and difficulty of early pregnancy loss needs to be addressed. Women should be supported in taking the necessary time to heal, both physically and emotionally. In 2022, the first national maternity bereavement experience survey will be carried out. It will ask women about their lived experience of bereavement care in Ireland’s maternity units and hospitals. It will be such a worthwhile exercise in order to find out what needs to be improved. Nevertheless, I am disappointed there is no mention of miscarriage in the women’s health action plan. I hope this matter will be added to future health action plans to improve the support available to women and their families. Women's healthcare does not begin and end at family planning. It is multifaceted, and I hope we will continue to see further development in all areas of women’s healthcare.

I very much welcome the commitments of this women’s health action plan and I commend the Minister and his team on ensuring they will come to pass.

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