Pauline O'Reilly (Green Party) | Oireachtas source

I will say at the outset how lovely it is to see the Minister of State in the Chamber for this really important day. This is World Menopause Day and it is kind of coincidental that I am bringing forward this motion, which is about free hormone replacement therapy, HRT. However, it is also a really good opportunity for us in this House to speak about the importance of women's lives and the fact that 50% of the population is going to hit the menopause. Some people are impacted and some are less so, but recognition must be given that even if a person is not impacted in terms of symptoms, it can be medically indicated that HRT is wise.

Going back a few decades ago, we simply were not living as long as we are now. That means that in the second half of our lives, we really have to make up for the fact that history has changed and we are more likely to get things like osteoporosis and diabetes. HRT plays a role in protecting us through that second half of our lives for want of a better word.

Over the last couple of years women and, indeed, men have been flooding the airwaves with their stories of menopause and the deep impact it has on families and communities, but most particularly women. We have a long history of silence when it comes to women and what goes on in our bodies and for us in terms of our health.

It has been absolutely really cathartic for an awful lot of people to share their stories but it is quite heartbreaking and devastating that it came to that for so many people. They had to actually ring up radio stations across the country. It is not just national radio stations; I hear it all the time across local radio stations. People are at the point of desperation, try to seek help and are not getting it.

I spoke in the Seanad maybe two years ago about menopause and nobody was speaking about it. It was purely because we were all so moved by the stories and we all spoke about it at the time. We do not want another two years saying, "Let us keep listening to women.". We can only listen for so long. Eventually, we want something to happen. The Minister for Health, Deputy Donnelly, and the whole Department - and I thank the Minister of State - have stepped up to the mark when it comes to women's healthcare. The Green Party did negotiate to put free contraception into the programme for Government but things have moved much beyond that. I am hugely grateful that we have been able to work as colleagues across the three parties in order to prioritise women's healthcare.

Even when we look at menopause, for instance, there are now six dedicated menopause clinics. There have also been guidelines set for GPs and other healthcare professionals for what to look out for when it comes to menopause. Indeed, there has been a public awareness campaign. One really interesting thing that has happened over the last couple of years, however, is also this radical listening programme that the Department engaged in - radical listening to women. It found that 86% of women said that going through the menopause has a big impact on their lives. We know that menstrual health in general means that people are losing days from work, and that includes through menopause. That is around the 45% level. Indeed, approximately one quarter of women find they are out of pocket from lost earnings because they have to leave work for various days off. We have a long way to go when it comes to acceptance within the workplace but we are definitely moving in the right direction.

In recognition of those 86% of us who are saying they are impacted by menopause, it is time to not just listen but to ask what we are going to do about it. Most women I know are not at a stage where they are looking for a menopause clinic. They are going to their GP or pharmacist and looking for support that way. It is quite straightforward, or at least it can be quite straightforward if somebody is looking out for it and if they know themselves what they need.

HRT is already provided by the State for those who have a medical card. That is really important to say. It is around the €6 million mark per year. We have estimated that it would cost approximately an extra €4 million to take all women into that bracket. We know organisations like The Irish Menopause say that cost is a significant barrier. We know also from surveys that have been done that cost is a significant barrier and people might ask why. For somebody who has X amount of earnings, for a cost of €20 or €40 per month, can they prioritise their health? We are asking women all the time to find money to pay for menstrual health products, contraception and HRT. The issue here is that many women are torn between putting food on the table for their children and prioritising themselves. It is, therefore, pushed out. The medical professionals would say that the earlier menopause is addressed, the better it is for a person's health outcomes.

Some people may need to take HRT for a long period of time. The majority of people take it for a much shorter period of a few years. Again, the cost to the State is relatively little. In terms of the cost to the State of doing nothing on the issue of menopause, we have the issues of bone health, diabetes, which I mentioned earlier, extreme depression and also that of marital breakdown, which has been reported by many people in this situation. People say they do not know what is going on for them and they are not feeling great. The people around them are also going through that experience.

I ask that we start the process of examining free HRT for everyone. It is the fairest thing to do. Some people have asked why we should have universal healthcare.That is meant to be the direction in which we are going anyway in healthcare. It is also not universal because it is women who are directly impacted, and they are the ones who face the biggest impact when it comes to the cost-of-living crisis. I have heard so many stories in recent years, as I am sure has the Minister of State, of people seeking help and not receiving it. I am not putting the blame on anyone for that, other than the State. The right guidelines have been put in place in terms of educating people so that they know what questions to ask when they go to a doctor but we still have the issue of cost to address. I know that since we entered government, funding for women's healthcare has increased year-on-year. In fact, I believe it doubled last year. Why not make that investment now in women in the second half of their lives in order to have better health outcomes? Can we really say it is full equality when we look at what is needed in the earlier stages of one's life, if we know what the health outcomes are of doing nothing for many people and the kind of pressure they are under?

I look forward to being supported by colleagues. I hope I will be. I am not the Minister. There is only so much I can do. The Minister, Deputy Stephen Donnelly, reached out to me today and thanked me for raising it and for pursuing issues around women's healthcare. I know that it is a commitment from the Minister, and that we have to do all we can as politicians in order to make that journey easier and to get the full co-operation and consensus that this is the right thing to do for everyone.