Linda Nelson Murray (Fine Gael)
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I am here today to talk about women's well-being and sexual health well-being. I am looking for a clinic for County Meath. County Meath has a growing population of about 240,000 people, and we can take it that 120,000 of them are women. Would the Minister of State believe that Meath has only half the number of GPs recommended by the World Health Organization for a county of its size? The county has the lowest number of GPs per head of population in the country at 54 doctors per 100,000 according to recent figures from the Irish College of General Practitioners. The WHO recommends 100 GPs per 100,000. If trying to get a GP appointment within two weeks, a person would be very lucky to find one. Consider a new patient who is trying to register in a GP practice in County Meath. There is very little chance. It is nearly impossible. Imagine being a young woman, concerned perhaps about family planning, about her sexual health, or maybe she has had a pregnancy scare and wants somewhere to go. She may do a little search on her phone and find there are no women's sexual health well-being clinics in County Meath. Not only that, it will take at least two weeks to be able to see a doctor. She might be a little bit embarrassed to go in to her regular GP.

I am speaking about a clinic that offers services in respect of sexual health, contraception, fertility, counselling, a woman's cycle and period problems, menopause, smear tests and urinary stress incontinence. There is a great website, sexualwellbeing.ie, that can guide a person in all aspects of sexual health and unplanned pregnancies but to go to a clinic, one must travel to Dublin or Drogheda. Surely towns such as Navan, Trim or Kells would be far more suitable locations for the people of Meath. We have a super hospital in Navan and a new primary care centre is opening. Perhaps they would be good locations.

It is worrying to think that in 2023, sexually transmitted infections in Ireland saw a notable increase with notification rates rising to 31% compared to 2022. I welcome that we have free at-home STI testing kits but, as we know, many young people are living at home well into their 30s with their parents and I doubt they would want a package like that arriving on their doorstep. They deserve privacy and discretion, which only a well-being clinic can offer. I also welcome that hopefully, we will launch the sexual health strategy soon after the previous one expired in 2020. It was a 2015 to 2020 strategy and although I am delighted we are launching a new one I wonder why it has taken so long at five years.

Given how freely we can all talk about the big "M" word that is menopause, with conversations around menopause happening in cafés, restaurants and even in the office, such is the normality of talking about this now because it is no longer taboo, imagine removing the stigma around sexual health by it being more accessible and a service that can be obtained every day. Yesterday I attended a talk in the AV room on urinary stress incontinence, which is also part of sexual health for women. I listened to three women speak on how this has impacted severely and hugely on their mental health. Some of them have had to travel abroad to access the right service for them. That, however is another day's Commencement matter, one that I would definitely bring in for another day's work given its huge importance to women.

Today I am calling for access to a well-being clinic in Meath. I love the saying that sometimes the bravest and most important thing one can do is show up. In fairness to the Minister of State, he has shown up here today to discuss this topic. I have shown up here today as a female Senator to discuss this. Now let the women of Meath be allowed to show up at a clinic that is open and ready for them, ready to help their health, their mental health, their sexual health, and to allow them to continue to thrive.

Timmy Dooley (Clare, Fianna Fail)
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I thank Senator Nelson Murray for a comprehensive and passionate expression of her concerns on behalf of her constituents. It is clear to me that they are in good hands with the Senator representing them. I will pass on the comments from the Minister for Health, who unfortunately cannot be here. The Minister sends her apologies and has asked me to communicate with the Senator in advance.

I thank the Senator for raising this important matter. Sexual health is a priority for the Department of Health and the Minister is very clear on that. The drafting process for the national sexual health strategy 2025 to 2035 commenced in 2023. The drafting committee included policy, service delivery, and clinical leads working within the Department and the HSE. It was decided that the strategy should incorporate priorities from the programme for Government of 2025, Securing Ireland's Future. These priorities included the commitment to supporting both sexual and women's health. The Senator's query is timely. The strategy and first action plan are at final stages of drafting and are being considered at ministerial level. The Department of Health hopes to be in a position to submit to Government for approval and launch it shortly.

One of the first priorities under the strategy, and the one that is already under way and resourced within the HSE, is to develop an integrated model of care for sexual health services. The model of care will examine the distribution, quality and the depth of sexual health services nationwide, assessing the regional delivery of care and identifying any gaps. It is at that point the issues in County Meath the Senator has outlined really well today would, I hope, be addressed in that context.

The new strategy in the model of care presents potential opportunities to broaden and deepen support for sexual health in line with the commitments included in our programme for Government. This work will be needed. As we all know, we have experienced rapid population growth with accompanying pressures on capacity. The Senator has eloquently identified those pressures with regard to getting access to a GP appointment. The Department of Health is currently scoping the potential to make more services accessible through GPs, family planning clinics, and community pharmacists where feasible, in addition to those provided through the STI and maternity services. Their work to enable better access to free contraception through pharmacies is progressing currently, along with treatments for common conditions.

In sexual health services, free HIV and STI testing and care is available through our network of 23 public STI clinics, six of which are located close to Meath in Dublin, Drogheda, Dundalk and Mullingar. The Senator has identified that but I believe we also need to move beyond just going to STI clinics. That has a certain stigma attached to it, no different to what the Senator has already said. The Senator has identified the complications in relation to the free at-home STI testing service but the service is accessible nationwide and is estimated to have increased testing capacity by around 33%, improving access and allowing STI clinics to prioritise those with symptoms. Service improvements are ongoing. In 2025, an additional €1.35 million has been allocated to free at-home STI testing, HIV pre-exposure prophylaxis PrEP, and the free contraception scheme.

Under the women’s health action plans we have invested additional funding of over €180 million since 2020. New services developed under the action plans include: additional gynaecology, menopause and fertility clinics; post-natal hubs; the free contraception schemes; period dignity supports; and more. As outlined in the programme for Government, we will continue to focus on improving women’s health and LGBTIQ+ sexual and reproductive health. The Department of Health is also supporting the international commitments, such as the sustainable development goals, to which Ireland is a signatory.

Linda Nelson Murray (Fine Gael)
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I thank the Minister of State for his response but I knew all of the answers in the response. First, I do not know why the strategy took so long to come to the time where it is nearly launched. I welcome that is to be launched and I hope it identifies that there is a major gap in County Meath. As the Minister of State rightly said himself, maybe some people do not want to be popping into an STI clinic. A women's well-being clinic is definitely what we need. Perhaps people would have to get a bus.That said, young people find it hard to even get a driving licence, never mind trying to get insured for a car, so they have to get a bus to Drogheda, Dundalk or Mullingar. It is not suitable. We need something in County Meath.

I look forward to reading the health strategy. I hope it identifies that Meath is crying out for a clinic like this. It remains to be seen. I appreciate the Minister of State coming to the House and answering this for me.

Timmy Dooley (Clare, Fianna Fail)
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Not at all. I take the Senator’s point. I wanted to set out in the first instance the position of the Government and the Department as to where they are at. Of course, the comments the Senator made and her presentation will be taken into consideration by the Department and the Government. She identified that there are practical issues on the ground in nearly every constituency. It takes time to get a doctor’s appointment. The Government, in a holistic way, is looking at the evolution of GP services and trying to ensure the gaps and pressures are eased into the future. In a holistic perspective in the roll-out in services to Meath, that growing population is factor, and it is being worked on by the Government.

I thank the Senator for raising these issues. They will be communicated back to the Minister and the Department. I hope that at some point in the future she will be back here reflecting, it is to be hoped, on a positive outcome. If it is not to her satisfaction, she will be more than well able to raise the issue again. We thank her for her presentation today.