Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I welcome the publication of this women's health action plan. It is good to have concentration of the issue brought under one document to put a focus on that but I would say it is important that we bear in mind that women's health issues should be mainstream issues. Sometimes when there are women's sections or women's groups, that can result in the sidelining of those issues. Women's health issues should be mainstream, at the front and centre of the health service.

As I say, it is good to bring the various elements together in this but it amounts to a repackaging of several initiatives that are already in train and have been announced for some time. For example, the provision of additional lactation consultants under the national breastfeeding action plan was planned between 2016 and 2021 but has not been fully delivered on. Four of the six regional fertility hubs are already operational, and that is a 2019 plan. The new specialist eating disorder teams were in a 2018 plan that has not been delivered on. The mother and baby units - the specialist perinatal mental health model of care - are from 2017. It is fine to bring those together. The Minister talks about radical listening and that is important, but we also need radical action in relation to implementing a number of those plans that are already in existence and are moving very slowly. I would say that the commitments still fall quite far short of what is needed or recommended in previous plans.

In relation to target setting, there are no targets for the reduction of gynaecology waiting lists, for example. Those waiting lists currently stand at 35,700. There are 35,700 women on waiting lists for gynaecology services. Targets for those would be welcome.

There is something that has been omitted from this and that is the role that cost plays in being a barrier to accessing care. Of course, that applies to people across the board, men and women, but for women, in particular, cost can be a barrier to accessing services and it is important that this should be referenced.

In terms of ensuring that services are responsive to women, it is important to have women involved in decision-making in the health service. We saw, for example, with the National Public Health Emergency Team, NPHET, and throughout the past two years in respect of Covid, there were very few women involved at a senior level. Time and time again, we saw the NPHET press conference and then the various Ministers who had responsibility in that area, and not a single women among them on a regular basis. It is important that we have women involved in decision-making, and on interview panels. I note what happened in relation to the new master of the Rotunda Hospital. Ten of the 13 people on the interview panel were men. We need people at senior levels in the health service and at decision-making levels.

In relation to radical listening, I echo what Deputy Whitmore has said. The Minister has not displayed radical listening in respect of the new national maternity hospital, which is the flagship development in respect of women's healthcare. The Minister and his predecessor listened to St. Vincent's, they listened to Holles Street but they did not listen to women. The Minister is continuing to fail to listen to women in respect of what they want. The vast majority of women - the Uplift survey showed that 73% of the public are in agreement with this - want the Minister to take steps to purchase the site for that hospital. It is utterly unacceptable that this was a deal that was hammered out between two hospitals without reference to the people who would be using that hospital - without reference to women - and that is a significant failing.

There is no justification for handing over a €1 billion asset to private interests, irrespective of whether they are religious or otherwise. That is the first point. Of course, this is a religious organisation, St. Vincent's Holdings, about which we know very little but which is the successor organisation to the Religious Sisters of Charity. The fact that the Minister is handing over the control of the hospital to that body is completely unacceptable.

I noted the Minister's comments this morning about the importance of independence and his statement that there would be an absolute guarantee of full independence, but there cannot be independence if the new national maternity hospital is a wholly owned subsidiary of St. Vincent's Holdings, which is the proposal on the table and what is planned by the Minister. In such circumstances, the new national maternity hospital cannot be independent. I urge the Minister to face up to that fact.

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