Duncan Smith (Dublin Fingal East, Labour)

I am delighted that we are able to bring this motion to the House today. As the Labour Party health spokesperson in the last Dáil, I was privileged to receive a number of briefings and to speak to members of the trans community, a community that is so often talked about but never listened to and a community that is attacked by presidents, authors, writers and other privileged people in this world. Trans people are used as a wedge in a culture war that they want no part of. When we listen to the trans community, as we are attempting to do, what do they tell us they want? They want healthcare in their own community, which is what any group or individual would want and what any citizen deserves. That is what they want. In an era when we are trying to decongregate and decentralise and have healthcare in the community for every person and group in society, why are trans people being dealt with differently? Why are we centralising everything through the national gender service at Loughlinstown? Why can trans people not go to their GP, like the rest of us can, and get the healthcare or the direction they need?

The statistics back up this motion and show that trans healthcare in Ireland is consistently ranked as the worst in Europe. There are over 2,000 people on a waiting list. Quite frankly, it is absolutely shameful. When I raised this issue with the previous Minister for Health, Stephen Donnelly, he agreed with the view that creating a model of care without involving the people directly impacted is neither best practice nor logical but that is what happened with the trans community. Its members have not been listened to or engaged with properly in terms of what is best for them in the context of their own healthcare.

We say, and it is Government policy, that ultimately the State aims to introduce universal healthcare through Sláintecare. One of the most important pull factors towards a universal healthcare system is equality of the care that is provided. A model of care in a universal system that does not hold closely the value of equality is not worth delivering. We have serious concerns about how transgender healthcare is delivered. I would openly label the national gender health service as wholly inadequate in its delivery of services, and that is being polite. The reality is that the inadequate access to healthcare that trans people in this country are getting is only compounding the existing challenges they face and perpetuating the cycle of marginalisation that they unfairly and unnecessarily have to endure. There is international best practice that we could be following. WHO guidelines are there for a reason and it is a choice not to follow them. People in our medical system can be brilliant. Indeed, they are fantastic people but the system is not delivering for the people who need care.

One of my core beliefs is that the role of a properly functioning Labour Party in any part of the world is to stand up for the vulnerable in society, those who are marginalised and do not have a voice, be they workers or members of the trans community. We have to do that. The truth of the matter is that trans people need a voice in this Chamber and they need action from the Government. They need a healthcare system that is going to deliver for them. I want to acknowledge the work that others in this Chamber are doing. The Chief Whip, Deputy Butler, informed us yesterday that she could not be here today and while we may not agree on all of the minutiae of the issue, she is an important voice in the Government. It must be acknowledged that attacks on her from people in this Chamber have been absolutely disgraceful. We will not tolerate such behaviour towards anyone in this House.

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