Bernard Durkan (Kildare North, Fine Gael)
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324. To ask the Minister for Health the extent to which women’s health specifically remains central to the provision and delivery of a reliable level and quality of health services in all areas throughout Ireland without exception; and if he will make a statement on the matter. [2321/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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Progressing women’s health is a priority for myself and for this Government. We made a strong commitment to promoting women’s health in the Programme for Government 2020 and are fully committed to the continued development and improvement of women’s health services and to working with women and girls to improve their health outcomes and experiences of healthcare across the whole life cycle.

Underscoring our commitment to women’s health was the establishment of a Women’s Health Taskforce in September 2019. The Women’s Health Taskforce, which includes representation from the National Women’s Council of Ireland and the European Institute of Women’s Health, continues to prioritise different issues each year with the overall aim of improving women’s health outcomes and experiences. Critical to this work is the process of listening to women - the Taskforce has so far listened to, engaged with and worked with thousands of women and hundreds of organisations representing women and girls across the country. The Taskforce commits to continued listening, remaining informed of women’s experiences of health and the healthcare system and working to respond as issues arise.

The Women’s Health Action Plan 2022-23 was published on 8 March 2022, marking International Women’s Day. The Action Plan identifies key actions to improve health outcomes and experiences for women in Ireland. It provides the foundation to address women’s whole health and help ensure that action on women’s health looks beyond reproductive health to make a real difference to women’s lives. I can assure the Deputy that Women’s Health continues to be one of my priorities going forward into 2024 and beyond.

Alongside the Women’s Health Action Plan, significant investment has been made into women’s health since the formation of this government. This has enabled the action plan to be delivered effectively.

We have seen significant investment in the area of women’s health. Budget allocations since 2021 for new developments for specific women’s health measures:

• 2024: €1.47 million
• 2023: €26.8 million
• 2022: €31 million
• 2021: €17 million
• Prioritisation of women’s health in our service provision is seen in the completed and ongoing work happening to improve healthcare for women across the country. There have been a number of key developments since the establishment of the Women’s Health Taskforce and the Women’s Health Action Plan 2022-23.
• Contraception: The free contraception scheme for women was launched in September 2022, initially for those aged 17-25. The scheme has been gradually expanded to include women aged 31 and under, as of 1st January 2024. Funding allocated to support the scheme is approximately €43.9m in 2024. Approximately 2,400 GPs, primary care and student health centres and family planning clinics, and 2,050 pharmacists are providing services under the scheme, across the country.
• Menopause: 6 Specialist Menopause Clinics to treat complex symptoms of Menopause, all of which are open and operational. A GP Quick Reference Guide on Menopause was launched by the ICGP in October 2022 to support primary care practitioners in treating menopause and referring patients to Specialist Clinics. The National Menopause Awareness Campaign (Radio, Online, Print, TV) was launched in two phases by the Department of Health to raise awareness and “lift the taboo” around menopause. Gov.ie/menopause was launched as a one-stop shop for information about menopause and its symptoms as well as advice on proactive management. VAT was removed from HRT in Budget 2023.
• Fertility: 6 Regional Fertility Hubs have been established to provided tailored, low-level intervention for patients referred by GPs with fertility-related issues. Many of these patients will be managed in these Hubs without the need to undergo invasive IVF or ICSI treatment. Investment to support publicly funded Assisted Human Reproduction (AHR) treatment has also been allocated and will see the first National AHR Centre established. As an interim measure, funding has been made available to enable eligible patients to access AHR treatment via private providers. This historic, a new initiative means that public patients are now being referred for AHR treatment which is to ‘go live’ since week commencing 25^thSeptember 2023.
• Gynaecology: A network of 20 “see and treat” ambulatory gynaecology clinics are in development, where an estimated 70% of general gynaecology referrals are suitable for management. 15 Ambulatory Gynae Clinics are currently open and operational, with additional clinics in development. The national network will improve access to services; help to reduce the requirement for multiple gynaecology appointments; help to ensure sustainability of service provision into the future given the significant waiting lists for this specialty; and will help improve clinical outcomes. Approximately 2,900 clinics were held providing care to an estimated 16,000 women in 2023.
• Maternity: Implementation of the National Maternity Strategy (2016-2026) is ongoing, consolidating progress made through €16m strategy funding allocated in 2021 and 2022. This has included further embedding the Strategy’s Model of Care in all 19 maternity units, increased access to community midwifery services (including through the opening of 5 postnatal hubs), improvement of infrastructure (including through additional home-from-home birthing suites, and upgrades to theatres and wards), the establishment of a National Perinatal Genomics Service (ensuring women across the country have access to critical testing both during their pregnancy, and in planning for future pregnancies), establishing an updated national antenatal education curriculum, and strengthening training and supports for maternity staff.
• Termination of Pregnancy Review: Review of the operation Health (Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021. The final Report of the Review was considered by Cabinet on 25 April 2023. The Government agreed that an implementation group would be established by the HSE to progress the operational recommendations. Significant progress is being made in respect of various recommendations in the Report. The proposals in the Report recommending legislative changes to the 2018 Act were referred to the Joint Committee on Health for consideration. The JCH report received and is being considered. By the end of 2023 17 of 19 maternity hospitals were providing full termination of pregnancy services, as prescribed in the 2018 Act, which includes Termination of Early Pregnancy (i.e., under 12 weeks).
• Safe Access Zones: I secured Cabinet approval to legislate for the designation of safe access zones around healthcare premises to safeguard access to termination of pregnancy services in July 2022 and published the General Scheme of the Health (Termination of Pregnancy Services (Safe Access Zones) in August 2022. Since that time officials have worked with the Office of the Attorney General and other relevant stakeholders to draft the text of a bill. This Bill was published at the end of June 2023 and initiated in the Houses in early July 2023. Legislation providing for Safe Access Zones has completed final stage in the Dail and is currently awaiting committee stage in the Seanad.
• Mental Health:The Women’s Health Fund provided investment in 2022 to support a range of services for women and girls, including digital mental health services access, improving perinatal mental health supports, enhancing specialist eating disorder supports, providing targeted mental health supports for marginalised women and women in addiction and responding to the needs of young girls at risk of developing psychosis. In 2023 the Women’s Health Fund provided investment for an initiative to support women in the development of protective factors to build resilience and alleviate mental health difficulties. In March 2023, the Minister for Health launched Embedding Women’s Mental Health in Sharing the Vision – a report by the specialist group on the National Implementation Monitoring Committee (NIMC) Specialist Group on women’s mental health. Work is on-going to implement its recommendations in the delivery of the policy. Work is ongoing on the implementation of the Model of Care for Specialist Perinatal Mental Health Services as a key priority under Sharing the Vision, our national mental health policy. Perinatal mental health services have now been developed in all 19 maternity units/hospitals and provide specialist support to women experiencing mental health difficulties in pregnancy. Perinatal mental health disorders are those which complicate pregnancy and the first postnatal year.
• Physical Activity: The campaign, ‘It’s My Time’, funded by a €300,000 allocation from the Women’s Health Fund and managed by Sport Ireland in collaboration with Healthy Ireland, was run in December 2022 and January 2023, following detailed marketing research on messaging resonating with women in the target demographics. It’s My Time encouraged women to prioritise their wellbeing by getting more physically active on their own terms and in their own time. The campaign ran across digital, video-on-demand, and social media and was supported by various sporting National Governing Bodies and the nationwide network of Local Sports Partnerships.
• Period Poverty: VAT was removed from all period products in Budget 2023. Period poverty funding has been increased to €914,000 in 2024, supporting period dignity measures in partnership with the HSE, community health organisations, local authorities and NGOs. In 2023, HSE supports were provided to all 9 CHOs and the Department funded 22 Local Authorities, 44 Family Resource Centres through the FRCNF and 10 NGOs to provide period dignity supports. The Healthy Ireland Survey, 2022, found that 51% of women currently having periods experience disruption to daily life as a result of pain and other adverse symptoms of periods, and that 24% have experienced indicators of period poverty.
• In addition to the above-mentioned developments, the Women’s Health Fund was established in Budget 2021. The fund responds to the issues that women have asked us to prioritise and align with the Minister’s priorities and the priorities of the Women’s Health Programme.
• The fund, to date, has supported and invested in a range of key service areas across women’s health including cancer screening and immunisation, primary care supports, maternity services and postnatal hubs, gynaecology, mental health and supports for marginalised groups.
• The Health Regions Implementation Plan commits to taking a population-based approach to how health and social care services are planned and funded, an approach which was championed in the Sláintecare Report. Allocation of existing healthcare resources to the Health Regions will be informed by factors such as age, sex, socioeconomic status, and rurality. An Expert Group will shortly be established by the Department to develop this population-based resourcing approach (PBRA). This means that we will be planning services around the health and social care needs of our entire population. The service needs of women are considered as part of this.
• Implementation of the services listed above represents significant development and advancement for women's health nationwide, but this remains a work in progress. I am committed to the full implementation of the Women's Health Action Plans, current and future, and will continue to drive progress in all areas of women's health to give women and girls the health services they deserve.