Dáil Éireann Debate, Tuesday - 12 July 2022
1103. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate provision has been made in the short term to deal with various aspects of women’s health with a view to ensuring minimum waiting times, early diagnosis and a rapid response; and if he will make a statement on the matter. [38106/22]
View answerImproving women’s health outcomes is a key priority for me, as Minister for Health, and for this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
Budget 2022 ring-fenced €31m in funding for new Developments for Women’s Health. This includes:
- €8.66 million additional funding for the National Maternity Strategy.
- €9 million to fund access to contraception for women aged 17-25.
- €5.3 million to grow access to “see and treat” gynaecology clinics; specialist menopause clinics; and specialist endometriosis services.
- €1.34 million to support initial establishment of a perinatal genetics service
- €0.71m investment in tackling period poverty for the first time.
- €0.54million to establish an expert Obstetric Event Support Team to support services and sites that report severe maternity incidents
- €0.25m additional investment in Sexual Assault Treatment Units.
In addition, Budget 2022 increased the allocation to the Women’s Health Fund (€10 million) enabling the Department to retain a responsiveness to meet women’s needs as they arise and accelerate progress on key initiatives where possible. On 28th April 2022 I allocated up to €2.5 million of the Women’s Health Fund to priority areas within the Women’s Health Action Plan, Menopause, Endometriosis, Post-natal hubs, targeted support for marginalised women. The NWIHP Annual Report published last Tuesday 5th July showcases the depth and breadth of progress underway in the HSE on these issues. Further allocations from this fund are in process.
My intention is to develop the infrastructure for women’s health nationally so that we can reduce waiting times, support earlier diagnosis and improve care and treatment across the board.
We can see significant improvements already in a number of important areas of women’s health:
1. Menopause:
The majority of women who seek support for their menopause can be effectively supported within primary care by their GP, however, approximately 25% of symptomatic women will require specialist medical expertise in menopause.
These more complex cases will be dealt with in several specialist menopause clinics being developed around the country, in the following locations:
- National Maternity Hospital
- Nenagh General Hospital
- Cork
- Coombe
- University Hospital Galway
- Rotunda
- The first of the dedicated specialist menopause clinics opened in the National Maternity Hospital December 2021.
- The specialist menopause clinic within the University of Limerick Hospital Group is located in Nenagh General Hospital and the HSE has advised that this clinic opened in May of this year.
Clinics in Limerick, Cork and Galway will be developed as part of the maternity networks in the South-South West, University of Limerick, and Saolta Hospital Groups.
- We have accelerated the delivery of menopause clinics with a further ring-fenced investment of €2.5 million in April 2022 that will support two additional specialist menopause clinics, at the Coombe and the Rotunda
- This will result in a total of 6 such clinics nationwide, one in each maternity network, for women who require complex, specialist care.
Clinical teams within the specialist menopause clinic setting will also provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care.
2. Endometriosis:
- As part of the work of the Women’s Health Taskforce, in April 2021, I announced the expansion of the endometriosis service at Tallaght University Hospital (TUH).
- This will deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis, with particular focus on advanced and complex cases for which there had previously been no ready access in Ireland.
- In addition, as part of this initial investment, services for the management of endometriosis at the Coombe hospital were also expanded.
Budget 2022 funding will enable the expansion of the endometriosis service at TUH as well as the establishment of a new service for more complex endometriosis cases at Cork University Maternity Hospital.
- This investment will result in 2 supra-regional specialist centres for complex care for endometriosis for the first-time.
- In April 2022, as part of a ring-fenced investment from the Women’s Health Fund, I announced funding for six additional interdisciplinary teams to support holistic treatment of endometriosis within each of the hospital networks. These multi-disciplinary teams will support secondary level care for women and complement supra-regional services for very complex care being established at Tallaght University Hospital and Cork University Maternity Hospital.
3. Gynaecology:
- My Department is working with the National Women & Infants Health Programme to improve access to gynaecology services, through the implementation of the Ambulatory Gynaecology Model of Care.
- This centres on the establishment of one-stop “see and treat” ambulatory gynaecology clinics.
- Roll out of the Ambulatory Gynaecology Model of Care began in 2020, and at present, 10 of these clinics are operational. This includes the new clinics at the Rotunda, Cork, Galway, Letterkenny, Waterford, - Wexford and Nenagh which are all operational, as well as the expansion of pre-existing ambulatory gynaecology clinics at the Coombe, National Maternity Hospital (NMH), and Mayo.
- Work is continuing in relation to recruitment, refurbishment and equipping of the remaining ambulatory gynaecology clinics that were funded in 2021.
- Funding has been provided under Budget 2022 which will facilitate the establishment of additional ambulatory gynaecology clinics at the last six hospital sites.
- This will bring the total number of these clinics to 20 nationally.
4. Fertility:
- Phase One of the roll-out of the Model of Care for Infertility has involved the establishment, at secondary care level, of Regional Fertility Hubs, in order to facilitate the management of, according to NWIHP, an estimated 50%-70% of patients presenting with infertility issues at this level of intervention.
- The completion of Phase One of the roll-out, envisaged before the end of this year, will result in six fully operational Regional Fertility Hubs, one in each of the maternity networks / Hospital Groups across the country.
- Phase Two of the roll-out of the model of care will see the introduction of tertiary infertility services, including IVF, in the public health system.
5. Maternity strategy:
- Government is allocating €8.66 million to the Maternity Strategy this year, on top of €7.3m allocated in 2021. This is the single biggest investment in the Strategy since its publication in 2016 (in 2020, for example, €1.5 million was allocated).
- The funding provided in 2021 allows for further development of community midwifery as well as specialist services. It is enabling us to expand breastfeeding supports, strengthen training and education supports for staff.
- The funding allocated for 2022 will enable the continued implementation of the National Maternity Strategy and will permit the recruitment of additional WTEs into maternity services across the country, including Consultants, Midwifery/Nursing posts, Allied Health workers, Healthcare Assistants and Administrative staff.
- These posts will cover a variety of disciplines, including, obstetrics, neonatology, endocrinology, anaesthetics, dietetics, midwifery, physiotherapy, and occupational therapy.
- The investment in 2022 will also improve the infrastructure of our maternity services by providing additional home-from-home birthing suites, upgrades to theatres and wards, as well as additional training and supports for our maternity staff.
- As part of the Women’s Health Action Plan 2022-23, this Government has committed to improving the health outcomes and experiences of women, with a targeted focus on marginalised women. In delivering on this commitment, I have allocated significant investment in 2022 for additional medical social work resources across the six maternity networks, significantly enhancing this support at what can be a very vulnerable time for these women.
6. 2022 Waiting List Action Plan:
I launched the 2022 Waiting List Action Plan on 25 February this year following extensive engagement between the Department, HSE and NTPF.
The Plan contains 45 actions to reduce and reform waiting lists across four main areas of work: delivering capacity, reforming scheduled care, enabling scheduled care reform, and addressing community care access and waiting lists. The Plan will also progress work towards achieving maximum waiting time targets, moving towards intermediate targets this year of 12 months for a hospital procedure and 18 months for an outpatient appointment.
As part of the Plan, €15m has been dedicated to reducing waiting lists in three priority areas, including gynaecology (in addition to paediatric orthopaedics and bariatrics / obesity).
The 2022 Waiting List Fund will enable the expansion of ambulatory gynaecology care in Tallaght, will provide access to additional theatre capacity for gynaecology activity in the Coombe, and will provide additional inpatient / day case capacity at CUMH through increased theatre sessions.
Implementation of the Plan is being governed by a Waiting List Task Force, co-chaired by the Secretary General of the Department of Health and CEO of the HSE.
www.gov.ie/en/publication/323b5-the-2022-waiting-list-action-plan/.
