Skip to main content
Normal View

Seanad Éireann debate -
Tuesday, 6 Dec 2005

Vol. 182 No. 3

Health Services.

I thank the Leas-Chathaoirleach and Cathaoirleach for allowing me to raise this matter on the Adjournment, which relates to sexually transmitted infections, or STIs. I tabled it because it has come to my attention that there are real difficulties and problems for people in Dublin seeking to access testing for STIs.

The Minister of State, being at the responsible Department, will probably know that there has been a steady but considerable increase in the number of STIs reported in Ireland since 1994 that cumulatively constitutes 173%. That refers in particular to such infections as chlamydia and syphilis. The former presents particular difficulties, in that for many women it is asymptomatic; to put it in plain language, one does not know that one has it. It can have very serious implications for later fertility.

We must considerably improve current facilities for testing. As matters stand, there are two or perhaps three public STI clinics in Dublin, St. James's Hospital, the Mater Hospital and, I understand, the former Baggot Street Hospital. If one goes to the walk-in clinics in St. James's Hospital or the Mater Hospital, one takes a ticket on a "first come, first served" basis. There is every chance that one may not be seen on the day that one attends, given the considerable demand for the service provided. If one wishes to make an appointment in advance, I understand that one can wait weeks or even months before one gets a suitable one. It is not a satisfactory state of affairs.

I have contacted GPs known to me, and they seem unsure regarding the extent to which testing is available from GP clinics. The GPs can administer the test and send off the sample to a testing laboratory. In any event, it is clear that it is quite costly, ranging in price from €80 to €150. The service that we provide for people who are in many case quite distressed and worried is inadequate and does not meet the need.

Of course, people have a responsibility for their own sexual health, but we must be of assistance to them, and in many cases they are very young. There was undoubtedly a peak in awareness in the 1980s and early 1990s, when public information campaigns centred on HIV and AIDS. Awareness of STIs generally, including HIV and AIDS, has diminished very considerably since. There is a clear need for the HSE to undertake a further campaign of awareness that will bring to people's attention the dangers not just of HIV but of the other diseases that I mentioned.

As the Minister of State will be aware, there are several campaigns run through the HSE and the former health boards. There is a national AIDS strategy, a national crisis pregnancy strategy, and a youth as a resource strategy, among others. However, there seems to be no overarching strategy or campaign to get across to young people the need to be aware of the danger of STIs and take whatever measures necessary — principally, safe sex — to ensure that they do not become infected.

We must examine radical measures such as increasing the availability of condoms and providing them free in places where young people congregate to get it across to them that there is a need to take measures to ensure safe sex. The typical cost of condoms purchased in a pub is approximately €4 for two, which strikes me as exploitative. It was one of the worst examples of rounding up following the introduction of the euro. We should try to encourage the owners of pubs and clubs to provide condoms for free where young people congregate in large numbers rather than charging such clearly exploitative prices. My primary thrust this evening is the availability of testing and I look forward to the Minister of State's response.

I wish to thank the Senator for raising this matter and giving me the opportunity to explain the position regarding initiatives to tackle the problem of rising rates of STIs. Since the mid 1990s, all countries in the EU have experienced significant and sustained increases in the incidence of STls. The Health Protection Surveillance Centre, HPSC, of the Health Service Executive, which is responsible for the collection of data regarding HIV-AIDS and STls, recently published annual figures for STls for 2004 and annual figures for HIV-AIDS for the first half of 2005.

The number of cases of STls notified each year in Ireland has been increasing in recent years, with the cumulative rate per 100,000 population for all notifiable STls rising to just over 270 in 2004, compared with just over 240 in 2003. In the first half of 2005, there were 148 newly diagnosed HIV infections, which roughly equates to one new diagnosis of HIV each day in Ireland and brings the cumulative number of HIV infections reported for all years up to the end of June 2005 to 3,912.

In 2000, the Department, through the auspices of the National AIDS Strategy Committee, NASC, published the AIDS Strategy 2000: The Report of the National AIDS Strategy Committee. The report makes a range of recommendations for dealing with HIV-AIDS and other sexually transmitted infections. The Department, through the NASC and its sub-committees on education and prevention, surveillance and care and management, is working to implement those recommendations.

The National Health Promotion Strategy 2000-2005 states that sexuality is an integral part of being human, and healthy sexual relationships can contribute to an overall sense of well-being. A strategic aim of the strategy is, "to promote safer sexual health and safer sexual practices among the population", and is intended to complement the 2000 report of the National Aids Strategy Committee.

Regarding sexual health promotion, three key dimensions are identifiable: the development and promotion of sexual health and relationships within the framework of personal and social skill development; HIV and STI education and prevention; and crisis and teenage pregnancy prevention. The development of policy, strategy and programmes for all the above should be informed by relevant research and best practice.

With regard to the promotion and development of sexual health and the prevention of STls among young people, it is recognised and proven that the development of services to meet the specific and unique needs of young people is an essential element of the work. The first Irish survey of sexual knowledge, attitudes and behaviour has been commissioned by my Department and the Crisis Pregnancy Agency to ensure that the development of policy and practice is based on a sound evidence and research base. The survey is currently at a well-developed stage and is being conducted by a consortium led by the ESRI and the Royal College of Surgeons of Ireland. The results will be available in 2006 and will significantly inform the development of strategy in the future.

Several regions within the HSE have significantly progressed strategies and programmes in this area, with dedicated human and financial resources allocated. The health promotion unit of the Department of Health and Children has provided finance for the development and implementation of much of that activity. Partnerships between statutory and voluntary NGOs to improve sexual health and promote safer sexual practices are common at a national and local level. Population group-specific work is resourced for particular high risk groups such as young people working in prostitution, gay men, intravenous drug users and the homeless.

The development and promotion of sexual health and relationships within the framework of personal and social development is a cornerstone of much of the STI prevention work. In the school setting the Department of Health and Children is working in partnership with the Department of Education and Science and the Health Service Executive to support schools in the introduction and delivery of social, personal and health education at both primary and post-primary level. Relationships and sexuality education is an integral part of this curriculum and remains a key priority for this work with schools.

Out of the school setting the health promotion unit of the Department works in partnership with the youth affairs section of the Department of Education and Science and the National Youth Council of Ireland to implement the national youth health programme. The aim of the programme is to provide a broad-based, flexible health promotion-education support and training service to youth organisations and to all those working with young people in the non-formal education sector. Within the context of this programme, a new training initiative entitled Sense and Sexuality was launched in recent weeks and is offered to youth workers to provide a policy for addressing the issues of relationships, sexuality and sexual health with young people.

Specific HIV and STI education and prevention programmes are also in place, such as a national public awareness advertising campaign to promote sexual health, which is aimed at men and women in the 18 to 35 age group, to increase awareness about safer sex and sexually transmitted infections. The overall goal is to increase safe sex practices, reducing the incidence of STI transmission and unwanted pregnancies among young people in Ireland. The campaign runs in third level colleges, places of entertainment such as pubs, clubs and discos, youth venues and some health centres. This national programme has been running for several years and a new and revised campaign is currently being implemented by the health promotion unit, which has greatly increased the number of venues targeted.

The health promotion unit also produces a range of awareness raising leaflets on STls and safe sex practices. These are available through health promotion departments in each Health Service Executive area together with condoms, which are available free of charge through HSE clinics to people at risk through drug misuse and those who are HIV positive.

As the Senator will be aware, there is a comprehensive range of programmes in place aimed at tackling the increase in STls through sexual health awareness promotion, and I am confident that the actions undertaken will have a positive impact on the sexual health of the population.

I thank the Minister of State for his comprehensive response. I appreciate the matter I raised was fairly comprehensive but I ask him and his Department to examine the whole issue of the availability, cost and accessibility of testing because real problems exist, certainly in the Dublin area, with which I am familiar, in accessing tests.

The Seanad adjourned at 6.05 p.m. until10.30 a.m. on Wednesday, 7 December 2005.
Top
Share