Mary Harney
Ceist:10 Miss Harney asked the Minister for Health the plans, if any, he has to deal with the level of waiting lists in respect of women awaiting sterilisation; and if he will make a statement on the matter. [12041/95]
Ceisteanna—Questions. Oral Answers. - Sterilisation Waiting Lists.
(Limerick East): Available figures indicate that there are in the region of 2,000 women awaiting tubal ligation procedures in public hospitals. A number of hospitals do not maintain formal waiting lists in respect of patients requiring tubal ligations since there is no waiting time in these hospitals once the decision to proceed with the operation has been made. Over 3,600 tubal ligations were performed in 1994 in 27 public hospitals. This figure does not include those procedures carried out privately.
I have today announced details for the allocation of the £8 million 1995 Waiting list Initiative funds, and gynaecological procedures, including tubal ligations, will be one of the speciality areas targeted. There are in excess of 700 such procedures scheduled to be performed for patients currently on waiting lists under this year's Initiative. I am confident that these measures will help to further alleviate the waiting times for those currently on waiting lists.
I welcome the information which the Minister has just announced. Is he aware that the findings of a recent Eastern Health Board survey on family planning services show that women who present at Holles Street, for example, and seek sterilisation are placed on a waiting list for up to 12 months? In Portlaoise they are placed on a waiting list for over 12 months. Does he agree that women who present at a hospital, be it public or private, and seek tubal ligation should not have to wait so long?
Is the Minister aware that the findings also show that 30 per cent of general practitioners have no expertise in the area of family planning services and that of the 139 general practitioners surveyed only 27 were women? Does he agree that if family planning services are to be enhanced throughout the country — this is the stated aim of the recent policy document — there is a need to ensure that GMS patients will have access to suitably qualified general practitioners who have received specialist training and to increase the number of female general practitioners offering this service?
(Limerick East): The reason the Eastern Health Board conducted the survey was that in the spring I issued guidelines on family planning services. It was asked to comply with these guidelines and report to the Department of Health by the last day of May with the necessary data relating to the effectiveness of the services.
There are inadequacies in the family planning services. The guidelines were promulgated so that the inadequacies could be identified by the health boards and remediated.
There are waiting lists for tubal ligations. The waiting lists in many of the 27 hospitals where this procedure is performed are not long as the statistics include those who have only been waiting for a fortnight. At 1 March there were 88 on the waiting list at Holles Street and 37 at Portlaoise General Hospital.
For how long?
(Limerick East): This does not seem to indicate that they will have to wait for up to 12 months. Difficulties were encountered at the South Victoria Hospital in Cork when a particular gynaecologist was ill. The waiting list seems to service women who live a long distance from Cork who attend the hospital for reasons of privacy and confidentiality. This makes it difficult to validate the list. One does not want to write to a general practitioner where a woman has attended the hospital for reasons of privacy and confidentiality.
Family planning services will be improved. The health boards have been instructed to provide a range of services to which women throughout the country will have easy access, to identify the inadequacies and report back to me.
The waiting list initiative covers gynaecological waiting lists. A total of 700 cases will be dealt with. Some hospitals because of their ethical code will not perform tubal ligation where it is sought for family planning reasons. There is an obligation on the consultant concerned to refer the patient to a hospital where this service is provided.
The findings of the same survey show that many GMS patients find it extremely difficult to obtain IUDs and diaphragms from their general practitioner. What proposals does the Minister have to ensure that all GMS general practitioners will provide a comprehensive family planning service? The findings also show that only 40 per cent of the general practitioners who responded have family planning leaflets in their surgeries. Does the Minister accept that if general practitioner services are to be improved a pro-active approach must be adopted, particularly by those general practitioners who provide a service to medical card holders who are most in need of such a service due to their socioeconomic circumstances?
(Limerick East): The reason the survey was commissioned by the Eastern Health Board was that I issued guidelines on family planning services. Most health boards reported during the month of June. The position is being assessed.
On the question of whether general practitioners have been educated in providing family planning advice, they have spent seven years in college and completed several years postgraduate training. Surely, they do not expect a misfortunate layperson such as myself to hold their hands. Professionals have to take responsibility for the delivery of the service and if they do not have leaflets they should obtain them from the health promotion unit in the Department of Health or health boards.
On the question of the availability of IUDs, it is stated in the guidelines that all contraceptive devices other than condoms will be available through the GMS for medical card holders. The Health (Family Planning) Act, 1979, contains a conscience clause for general practitioners. This enables a GMS general practitioner who does not want to provide contraceptive devices to opt out. There is an obligation on service providers, through the Department of Health, to ensure that a service will be provided by another general practitioner.