Seanad debates
Wednesday, 24 November 2021
Nithe i dtosach suíonna - Commencement Matters
Health Services
10:30 am
Joe O'Reilly (Fine Gael)
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I welcome to the House our colleague, Minister of State, Deputy Feighan, who is one of our former distinguished Members. I wish him well with his recovery.
Jerry Buttimer (Fine Gael)
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I thank the Cathaoirleach for picking this very important topic. I welcome the Minister of State and thank him for being here and also wish him well. I commend his work on his brief so far. He has been very proactive and I commend him on the work he has done in terms of sexual health and sexual well-being. The sexual health strategy is so important.
Next Wednesday, 1 December, is World AIDS Day and a day of visibility. However, I am wearing the red ribbon here today as a reminder to all of us that it is not just one day. The issue of PrEP is one that has become a source of contention of Cork, and it should not be, because Cork is our second city. To be fair to the Minister of State and the Department of Health, the funding is available. PrEP has become a very important tool and asset in the fight against HIV in the world. I want to stress that the Cork Sexual Health Centre is doing Trojan work. The outreach, engagement, support and services are fantastic and are helping so many people.
A resolution is needed in Cork in the availability of PrEP. Funding is approved and has come from the Department and CHO 4, covering Cork and Kerry. The roadblock is that there has been no implementation of the funding. I appreciate that we have a pandemic and the resources and staff of the HSE are stretched. A standalone PrEP clinic is needed, however, in Cork, our second city. The positions that should be created must be advertised and filled.
A central part of the sexual health strategy is access to critical services and supports. I appeal that the new sexual health strategy will include deliverable measures to improve access to HIV and sexual health services, such as PrEP, in Cork city. There is a global commitment to meet the end of HIV by 2030. As part of that, the supports and services linked to PrEP are essential. Equally, I appeal that as the Minister of State meets with different organisations as part of the sexual health strategy, there would be engagement and inclusivity with all stakeholders, not just with people within the Department. The Minister of State has been very open and engaging with all of us who have met with him and the groups he has met around the country. I thank him for his work and I wish him well.
This is an important issue. It is not just about World AIDS Day. It is about the ongoing provision of services and supports in the fight against HIV.If we cast our minds back to where we were in the 1980s and compare it with today, we will see that we are in a much better place now. We can be in an even better place with the supports and services available. I thank the Minister of State for being here. I really appreciate it and thank him for his work.
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Senator Buttimer for giving me an opportunity to update the House on this matter. Sexual health is a priority for the Department of Health. This was evidenced by the publication of the National Sexual Health Strategy 2015-2020, the first major strategy to tackle this vital area. Good progress has been made with the implementation of the strategy since 2015. The Department of Health, along with the HSE sexual health and crisis pregnancy programme, SHCPP, has worked hard to built important partnerships with a range of community and voluntary groups, all of which are working with us to implement a range of important sexual health initiatives. Work has now begun on a review and refresh of the strategy and this will continue in 2022. The treatment of HIV is a priority item within the strategy. As we approach World AIDS Day, we have a good opportunity to take stock of where we are in the fight against the virus.
In recent years we have seen the launch of two major initiatives to intensify our response to HIV in Ireland. The first of these saw Ireland joining the Fast-Track Cities global initiative, which aims to boost HIV prevention and treatment and to reduce stigma. The implementation of this initiative includes expanded community HIV testing and outreach in key urban areas and centres; targeted outreach to key at-risk groups; public campaigns on stigma reduction and promotion of the PrEP service; and the development of a co-ordination, monitoring and evaluation workstream. Steering groups, which include representation from the Department of Health and the SHCPP, have been established and are now in place. They are working to progress this initiative in the participating cities of Dublin, Cork, Limerick and Galway. The second initiative was the introduction of a national programme of HIV PrEP. Funding of €5.4 million was secured for PrEP in 2020, including an allocation for the recruitment of additional staff, as Senator Buttimer rightly said. The funding and roll-out of this programme has continued in 2021. While the PrEP service remains fully funded, implementation has been impacted as a result of the Covid-19 pandemic. All health services, including STI, HIV and PrEP services, are continuing to face constraints resulting from the impacts of the Covid-19 pandemic. These constraints include attendance by appointment only or online as a result of the need to maintain social distancing, and the necessary redeployment of personnel to diverse Covid-19 related duties which include testing, contact tracing, vaccination and front-line patient care.
The Cork PrEP service commenced in South Infirmary Victoria University Hospital in April 2020. There are 294 PrEP service users registered with the PrEP clinic in the hospital. Existing PrEP users continue to be seen for PrEP review and monitoring as prescriptions are required. The recruitment of a PrEP clinical nurse manager for the service is a priority for the HSE and is actively being pursued. The service closed to new PrEP service users on Monday, 4 October 2021, and will remain closed to new users until the clinical nurse manager is in post.
Jerry Buttimer (Fine Gael)
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I thank the Minister of State for his reply. The Fast-Track Cities initiative, which he mentioned, is an important part of what we are trying to achieve in our fight against HIV and AIDS. The interesting thing is that the funding has been approved, notwithstanding the remarks of the Minister of State. The key point I want to make is there is a need to have a resolution to the post being filled. As the Minister of State said, the service has been closed to new PrEP users since 4 October and will remain closed. I hope the Minister of State will impress upon the HSE the urgency and importance of this service and this facility. I hope this will be prioritised in real time, not in HSE time because that can go on forever, as we know. I do not mean to be rude or disparaging when I say that, but there is a need to progress the good work being done to ensure we meet our commitments in the sexual health strategy. Our second city is not open as a PrEP facility for men who require this service, and we cannot allow that to continue. I appeal to the Minister of State to use his powers to fast-track the recruitment of a new clinical nurse manager. As he knows, the HSE can take forever to fill a post. I hope it will not be that way in this case. I thank the Minister of State for his commitment and support and for being here this morning. I appreciate the work he is doing in the Department.
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Senator Buttimer for his significant contribution to the House on this important topic. I wish to conclude by providing some detail on another important sexual health initiative which is currently in progress. The Department of Health is happy to support the HSE's home STI testing pilot project in Dublin, Wicklow, Kildare, Cork and Kerry through the Sláintecare integration fund. My colleague the Minister for Health, Deputy Stephen Donnelly, was pleased to be able to secure funding of €3.3 million in the recent budget for the continuation of online STI testing. Integrating online STI testing services with established public STI clinics is an effective and efficient way to increase access to and capacity for STI testing services. This allows people to use online platforms and tests for STIs in the comfort of their own homes.
Senator Buttimer said that this post needs to be filled as a matter of urgency. I will bring his concerns back to the HSE to try to get it filled as quickly as possible.