We’ll keep our vows on women’s healthcare
IT will surprise few to learn that Ireland has historically underinvested in Women’s Health and in particular gynaecology services. These were often viewed as a ‘Cinderella service’, where access was not prioritised, surgeries regularly cancelled and limited opportunities for the doctors and nurses to develop and protect these important services.
When I became Health Minister. I was determined to change that. I promised a revolution in women’s healthcare and that revolution is well underway.
Since 2021 we have seen unprecedented investment in Women’s Health, and we are seeing very significant improvements in both range and access to these services.
We have separated out non-cancerous gynaecology into four targeted and dedicated pathways for women. For each of these pathways, the HSE’s National Women and Infants Health Programme developed a model of care, which I funded to provide dedicated access for women to specialist care.
‘See and Treat’ gynaecology clinics
Based on a successful model in Mayo University Hospital, this requires each of 19 identified hospitals to have a dedicated service, where patients can be appropriately seen and treated quickly.
We have invested €9.2m recurring costs and millions more in new or refurbished buildings for these services.
Last year, with 12 hubs operational, an additional 10,000 women were seen. In 2023 that figure is on target to be an additional 15,000 women. When the model is fully operational approximately 25,000 additional women will be seen every year.
As of now, 15 of these 19 hubs are operational. The 16th service is due to come on stream during the first week in December.
The hospitals where the service has yet to start – Tallaght, Kerry and Portiuncula in Galway – all require significant capital development. Kerry and Portiuncula will open next year while Tallaght is already seeing patients, albeit in a limited way.
Endometriosis
A difficult condition to diagnose, women have in the past gone without a diagnosis, and therefore treatment for long periods of time. We have developed a model of care, starting with a GP presentation.
There is now a referral pathway to local gynaecology services and a network of regional endometriosis hubs depending on clinical need. Those women with a severe diagnosis can now be referred to one of two specialist centres where a highly skilled team of clinicians can decide on the best treatment, including the necessary surgery to address the issue.
This service is open and seeing patients, following an investment of over €3m, enabling women to be diagnosed and treated in a timely manner.
Menopause
This is a condition that affects all women, but for which there were, until recently, very few structured services. In 2021 our Women’s Health Taskforce prioritised investment in menopause. The HSE worked with the maternity networks to develop a pathway for women, into six regional specialist centres.
GPs can now refer women with complex medical histories, those for whom the usual treatments do not work and those women who are experiencing side effects from treatment.
These six specialist regional clinics have been rolled out since late 2021, with all six clinics now open.
Fertility
We now have a model of care for fertility which sees the patient start with their GP, and we have invested €3m in six regional fertility hubs.
Since September, Assisted Human Reproduction (AHR) has been available to public patients. We have developed access criteria for patients and engaged private providers who will provide AHR services, to patients referred from the Regional Fertility Hubs.
To date 100 patients have been seen by private providers and many more will begin that journey in the coming months. Regional Fertility Hubs have experienced a surge in referrals, with 1,000 women referred by General Practice, since the start of August.
Conclusion
As a result of all this work and investment in new pathways we have seen a 30% increase in the number of women referred for gynaecology services in the last two years.
Importantly we’ve also seen a 9% reduction in the number on waiting lists in that time.
Significantly, the length of time women wait for an appointment has also been dramatically reduced, with 76% of women nationally now waiting less than six months, up from 55% in September 2021.
These improvements are even more obvious at local level as services open and then bed down. In Letterkenny 99% of women are now seen in less than six months, in Limerick 98%, Cork 95% and in Dublin’s Rotunda it’s 93%.
We have seen Women’s Health prioritised during this Government as never before. We have had sustained investment and significant improvements in both the range of services and access to those services, for women.
More than €45m has been invested in gynaecology alone.
It is far from perfect, we must continue the momentum, but let no one tell you we are not making significant progress in an area of healthcare that was neglected for far too long.