Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the Acting Chairperson and Senators for inviting me to speak about the women's health action plan and the national maternity hospital, NMH. The new NMH has, of course, been recently debated extensively and the concerns raised regarding ownership, governance and influence have been addressed in the legal framework that has been published. In approving the legal framework, the Government was satisfied it had achieved the State's objectives to ensure all legally permissible services will be available, with no religious influence in the operation of the new hospital now or at any time into the future, to safeguard the State's investment and, critically, to ensure we will have a state-of-the-art, modern, co-located national maternity hospital that will be able to expand greatly and deepen the services provided.

The State will own the hospital and the land for 299 years under leasehold ownership, a common ownership approach with multiple operators, such as apartments. The new hospital will be entirely secular. Its founding rules, contained in the constitution of the new NMH, state there can be no religious ethos or influence whatsoever. The published legal documents make clear there can be no religious ethos in the provision of any services or operations at the new hospital. The documents also state that not only can the new hospital provide all services but that it must do so. The State, via the Minister for Health, will have the power to intervene directly if the hospital fails to meet these requirements relating to services and remaining secular. All services that should be provided in a maternity hospital, including all those currently provided in Holles Street, will be available in the new NMH. To further address concerns about the availability of services in the new NMH, in the context of the Government's decision of 17 May, it was also agreed an annual report will be published on the operation of services at the new NMH for five years from when it opens.

These past few weeks of debate on the matter have helped to highlight the overwhelming support from clinicians, midwives and doctors for this project to proceed. It includes unanimous support from the clinicians, doctors and midwives at the National Maternity Hospital and the directors of midwifery from all 19 maternity units in the country. There is also clear support from the medical board of St. Vincent's Healthcare Group, representing more than 250 clinicians. I fully share the confidence of these clinicians and experts who support the project. We cannot delay this process any further. As I said recently, the need is too great and the delay to date has been too long. The task now is to get this hospital built as quickly as possible in order that we can improve experiences and outcomes for women and girls for generations to come. I hope we can all work together to ensure the hospital will now be built as quickly and effectively as possible.

Turning to the women's health action plan, improving the outcomes and experiences of women in our health service has been a priority since I became Minister for Health. On International Women's Day in March of this year, the women's health action plan was launched. It is the first plan of its kind in Ireland and represents a revolution in women's healthcare services here. We have listened to women throughout Ireland over the past two years. They have spoken of their experiences of our health service and told us which issues they feel need most attention. Their requests were simple, that is, to keep listening to them, not to make promises but to take action, to respect them as experts through experience, to empower them with trusted sources of information and, most important, to give them access to the women’s health services they need, that is, services that are accessible, expert and empathetic. The women's health action plan places women in control of their own experiences in healthcare. We place women's health at the heart of everything we are doing in the plan. We are advancing initiatives that will have a direct, positive experience on women's experiences and outcomes.

Last year, I had the great honour of opening the first publicly funded dedicated menopause clinic in Ireland. This year, five further specialist menopause clinics will be opened, meaning there will be six such clinics by the end of the year serving the needs of women experiencing complex menopause symptoms. Last year, we opened nine see-and-treat gynaecology clinics, while this year, we are opening a further 11, creating in just two years a national network of 20 such clinics. These clinics provide necessary care to patients in just a few hours in one visit, instead of multiple visits over many months and sometimes well in excess of a year. It is one of the vital steps we are taking to reduce gynaecology waiting lists.

Last week, I visited the new women’s health services on the Lee Road, Cork. The clinic is focused on addressing waiting lists for all related investigations a woman may require. For example, a woman with urinary incontinence requires a diagnostic test called urodynamics prior to a doctor's consultation. In February 2019, the waiting list for this procedure stood at 500 patients and the average waiting time for those patients was two years. Today, the figure has fallen to just 77 women waiting and the average waiting time has fallen to just two weeks.

In the coming months, we will introduce free contraception for women, beginning with 18- to 25-year-olds, and set up four new postnatal hubs that will provide wrap-around care to mothers in those critical first weeks with their babies. This plan also brings a new spotlight to women's mental health and well-being, including growing supports relating to self-harm, setting up new eating disorder teams, examining supports needed by carers, a majority-female workforce, and developing an inpatient mother and baby unit.Six publicly-funded regional fertility hubs have been established to support women and their families in their fertility journeys. Women expressed the need for more support in making the choice to breastfeed. As colleagues will be aware, we have the lowest breastfeeding rate anywhere in Europe. In response, we have more than doubled the number of lactation consultants trained to provide specialist hands-on support. That now includes all 19 maternity units and for the first time we have national coverage.

We have prioritised initiatives like rolling out the first maternity bereavement study this year, an important study which allows us to understand how best to help mums, dads and families during the hardest time imaginable for any parent. All of this has been made possible through a significant increase in funding for women's health services. To put this in context, in 2020 new development funding for women's health services was about €4 million. The full-year cost for the new developments for this year alone will be €50 million. That gives Senators a sense of how this investment has been prioritised.

I would like to acknowledge the major work done by the women's health task force, my Department and healthcare workers across the HSE. I also very much acknowledge the tireless work done by Members of the Oireachtas, including many Senators - in many cases the work was led by Senators - who have campaigned for years for many of the measures being rolled out in the women's health action plan. I hope the plan will be seen not so much as a plan of Government, but rather as a plan of the Oireachtas. Most importantly, I acknowledge the time and participation of the women across Ireland who contributed to the plan and the radical listening exercise, and gave up their time and shared their experiences, sometimes very good and sometimes very difficult and painful experiences. That input, and their voice and testimony, have helped us to create a plan and design services that are what women have said they want and need.

We will all agree that we have wonderful clinicians in Ireland working in women's healthcare across the country. In spite of this, there has never been sufficient investment in women's healthcare here. There has never been the range and depth of services needed for generations, and which are still needed today. We are changing that. We are not interested in making things a little bit better each year or having marginal incremental change. Our ambition is to radically improve women's healthcare services in Ireland and to do so very quickly. Between last year and this year alone, we aim to have put in place 20 see-and-treat gynaecology clinics, six specialist menopause clinics, six endometriosis clinics, six regional fertility hubs, nine eating disorder teams and 24 additional lactation consultants.

We will have fully funded the national maternity strategy this year and last year for the first time. We will have expanded perinatal mental health teams to all 19 maternity units. We are investing in period poverty. We are strengthening sexual assault treatment centres. We are introducing free contraception, starting with 17- to 25-year olds. We are expanding research into women's health. We are increasing support for GPs for women's health and will launch a HPV vaccine catch-up programme. There is more in the plan. It will take several years to build up the level of services to where they need to be. Over last year and this year, we have got off to a very good start.