Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank everyone for their contributions. I have a wrap-up speech but I am not going use it. Instead, I will try to respond to the questions and points raised because this has been a useful debate.

I echo the sentiments expressed by Senators from across the Chamber that we have to get women's healthcare right. We have never got women's healthcare right. I have no doubt that if men had babies, Holles Street would look like the deck of the Starship Enterprise or the Blackrock Clinic or some other gorgeous place. There is no question about it. The maternity hospitals are not fit for purpose. We have extraordinary clinicians throughout the country in obstetrics, gynaecology, midwifery and so many other areas. We have not given women's healthcare the investment and focus it needs.

Unfortunately, we have a deeply dark past and history when it comes to women's sexual and reproductive health in this country. We know that and we all know the reasons for that. What I want, and I think all of us want, is a revolution in women's healthcare. We do not want marginal change or for things to get a little better. We need to do women's healthcare fundamentally differently. That means large amounts of money and cross-party political agreement in the Oireachtas to enable our phenomenal clinicians to do the jobs they know how to do and to do them better and better. We need this in women's health.

The women's health task force is amazing. It has already identified many areas. For younger women, it identified areas such as mental health, especially around eating disorders, wellness, sports and activity. There is a great deal of focus on team sports and sports that have been more traditionally played by boys rather than girls and we need to rebalance that. Sexual and reproductive health is essential in many different ways. Obstetrics and gynaecology are important. Menopause is now being flagged. There was considerable focus on it publicly recently but the Department and the women's health task force were already examining the issue.

I acknowledge the role played by Deputies and, in particular, Senators given that we are in the Seanad today. I have been working on many of these issues with many of the Senators who contributed to the debate this morning. When Senator Chambers and I were in opposition, she raised with me the issue of endometriosis. We have set up the first specialist clinic in Tallaght and we are going to do much more. Various Senators spoke about domestic surrogacy, international surrogacy, donor-assisted human reproduction and IVF. We are moving on all these matters. I will soon introduce legislation on surrogacy. Three Departments are working on that.

The maternity strategy from 2016 is very good and everyone bought into it but it never got any money, until this year.This year, I allocated five times more money to the maternity strategy than it got last year, so it is happening now. They are hiring midwives and creating more choice for women around midwifery-led care, home births, community-based care and so forth. We funded an extra 24 lactation consultants recently and we will keep going. We have one of the lowest breastfeeding rates of anywhere in Europe; that has to stop. It must change and we are going to change it. We are setting up new fertility clinics and hubs. There are new "see and treat" gynaecology centres that are very important. There are some great ones already in existence, but we are expanding on them. For the first time, we have funded a clinical lead out of the Irish College of General Practitioners, ICGP, for women's healthcare and primary care. This has been mentioned by various Senators this morning. That has to be just the beginning. I have met with the cross-party women's caucus of the Oireachtas and we must keep meeting up. We have an opportunity here - I am acutely aware that I am a male health Minister saying this, but so be it, there is nothing I can do about that - if we work together on this. There is strong cross-party support in both Houses to start doing women's healthcare differently and make it something we can be immensely proud of. There is no reason we cannot do this. Other countries can and so can we.

I echo the importance of cervical screening. I was taken by the many Senators who got that message out there, notwithstanding what was an horrific and unacceptable situation for the women involved in the 221+ group, which is what today is about. It is wonderful to hear so many Senators echo the point that our cervical screening programme is one of the most advanced in the world. We have some of the highest participation rates and most advanced technologies in the world. I may have my numbers slightly wrong but, from recollection, deaths from cervical cancer were falling by 7% a year, from the year CervicalCheck was set up. I remember the graph. The rates were going up and up, but the year CervicalCheck came into being, they started going down. Clinicians from around the world come here to understand how we have such a high participation rate. It is partly because of the advocacy of political leaders like Members of this House and encouraging people. We have the same thing with vaccines generally. It is wonderful to hear the call being pushed again and again.

Not everything has been possible to deliver on, and the issue of recurrence was raised here this morning, but a lot has been done. Dr. Scally's very good report came up with 170 recommendations. Some 155 of those have been fully implemented and progress is being made on the last 15, so that is pretty good. There were a lot of recommendations that involved a lot of work, and credit goes to our clinicians working in the HSE and officials in the Department for helping to make that happen. There was an ex gratiapayment of €25,000 to recognise the trauma of the non-disclosure aspect of what happened. Some 170 women applied for this and all 170 women received it. I appointed a new independent chair to the steering group which the 221+ group had asked for. There was progress made on medical cards, and other issues, as well. However, not everything was possible. The issue of recurrence is one of the big ones and I believe it is one of the reasons not as many women or families have applied. The 221+ group decided not to support the tribunal, which was entirely its right to do. We know the legal advice to some women and families is not to support the tribunal. Can I take another minute, nóiméad amháin?