Dáil Éireann Debate, Thursday - 18 January 2024
5. Deputy Duncan Smith asked the Minister for Health if he will commit to meeting transgender advocacy groups to discuss the provision of transgender healthcare; and if he will make a statement on the matter. [1975/24]
Amharc ar fhreagraMy question relates to transgender advocacy groups and the Minister's engagement, or lack thereof, with said groups. It is a request that he and senior officials in the HSE commit not only to having one meeting but holding a series of ongoing engagements with the relevant transgender advocacy groups.
I do not think that dig is fair. I respectfully disagree with the Deputy on that. I am happy to meet the stakeholders. I have met TENI and other groups before and I am happy to meet them.
I am meeting a constituent of mine soon who was in contact. She is the parent of a transgender child who wants to talk through some of the issues that they are facing, which I am familiar with and I am very sympathetic to. I am committed to the development of a model of care that delivers proper services for this group of people. It is a very small and very vulnerable group of people and they need to have access to proper, appropriate and integrated care, including acute care and community care. Quite frankly, as we all know, they do not have access to that in Ireland right now and I am not satisfied with that. To be perfectly honest with the Deputy, I am also not satisfied with the pace at which this is progressing. There has been a hold-up for a long time in appointing a psychiatrist to lead the new model of care. What I can share with the Deputy is that an offer has now been made to a person. However, that process is not complete yet so that is all I can say at this point.
The HSE is going to consult widely with stakeholders, including TENI and others, in the development of the new model of care. The HSE is working to identify new pathways. As we know, the Tavistock centre has now been decommissioned and the UK health authorities have opened different centres on the back of the Cass report. Ultimately, we need those services available to people in Ireland and that is the objective. Of course, I am happy to continue meeting with stakeholders.
In terms of the appointment of the HSE clinical lead, while the groups are obviously aware that they have no formal role in such an appointment, given that this is a small and vulnerable group of people, they feel that engagement regarding that role or position would be important. This community has insights in terms of who provides the specialist care and who would give confidence in the provision of the care that is needed. The National Gender Service, NGS, at the moment is not national. It does not reach many corners of the country at all and is not operating as a gender service in the context of healthcare in any way, shape or form. The Minister has acknowledged that an awful lot more work needs to be done. Trans Healthcare Action and TENI believe they need more engagement and I also believe they do and that such engagement has to be ongoing. They do not feel they are getting the engagement they need. We really need to see that to provide confidence to these groups and to this community that they are being listened to and being heard.
It is disappointing but very useful to hear that feedback. On the back of this discussion, I will talk to the Department and the HSE. Of course, I can meet the groups and am happy to do so again but ultimately they need to be talking to the people who are designing the model of care. Of course, it can be useful to talk to a Minister but really, they need direct input into the model of care that is being developed.
I am happy to say that we have allocated funding for this year, a sum of €100,000, for the establishment of a new team, which is important. The HSE is working on an interim solution, an alternative pathway for children and young people who are experiencing protracted waiting times. They are waiting too long and the current situation is not where we want to be. Discussions are under way with paediatric endocrinology in Children's Health Ireland and with our psychology services to put an interim solution in place until we have what these young people need and deserve, which is a fully dedicated multidisciplinary service.
Regarding the model of care, the NGS states that patient support and advocacy organisations will be involved in governance and service development. However, after five years there is still no member of the trans community on the NGS governance committee and no member has been invited to participate in the development of the service. These are some of the tangible improvements that could be made to increase confidence. Across the NGS, the Department of Health, and among senior figures, including chief clinical officers, in the HSE, we need that level of engagement. This is something to which I will return. I accept the Minister's bona fides in terms of wanting to get this service right and wanting to deliver, but we need to see action and engagement to engender confidence in the community. It is a community of which I am not a member but when I speak to advocacy organisations, I hear what they are saying and I think the Minister hears them too.
I take that feedback very seriously. We cannot have a situation where we are developing a model of care for a group of people who are not involved and whose voices are not heard. We are trying, although it does not always work and we are not always successful, to move to a situation where the patient voice is front and centre in everything we do. We are embedding it in legislation in the Patient Safety (Notifiable Incidents and Open Disclosure) Act and through new regulations within the HSE. We are not getting it right all of the time and clearly, if the trans community feels that they are outside the door and nobody is listening to them, then whatever is happening is clearly not working and needs to be looked at. I commit to going back to the Department and the HSE on this. I will also ask them to revert to the Deputy with a note on what actions can be taken.
