Debate contribution: Women's Health Strategy

Debate contribution by Mr Robin Swann on 13 February 2024.

MLA: Mr Robin Swann
Party at the time: Ulster Unionist Party
Date: 13 February 2024
Type: Debate contribution (made as a minister)
Business: Private Members' Business
Heading: Women's Health Strategy
Assembly identifier: Official Report component 4206288

Text

Like others, I congratulate you and welcome you to your post, Mr Deputy Speaker. I thank the Members for tabling this important motion, but I also thank all the contributors to the debate for their openness, honesty and personal contributions. That is the strength of this place: when we debate things that affect all the people of Northern Ireland. I thank everyone for their contributions today and the tenor that we have had. Many of the issues that have been discussed today are already priorities for my Department, and I assure colleagues that work is actively ongoing to address the challenges, despite the difficult financial position that the health and social care system faces. Progress on those key issues will be high on my list of priorities as Health Minister. That is why, as my party colleague said, as Minister, I am keen to support the motion and the amendment. I can update the Assembly about the fact that my Department is in the early stages of developing a women's health action plan for Northern Ireland. That will bring all of that work together for the first time in a unified plan to demonstrate what we are trying to achieve and to highlight where greater attention and action will be needed. It will be a similar approach to the one that I took in developing our mental health strategy. We produced the mental health action plan first to allow that time frame to make sure that the strategy was able to engage across the trusts, political bodies and all stakeholders. With your indulgence, Mr Deputy Speaker, I pay tribute to the organisations that are represented in the Public Gallery, but I will not name them all in case I miss one. I will speak later about the action plan, but first I will pick up on some of the issues that have been discussed and outline the work that my Department is doing in those areas. As Órlaithí Flynn pointed out, each of these topics is worthy of a debate and a discussion in this place rather than just being part of a general motion. I am sure that members of the Health Committee will take that forward, and I look forward to working with those new members. I also pay tribute to those with whom I worked in the past for the way that we were able to approach health in this place. As has been said, women and girls account for 51% of Northern Ireland's population, yet not enough focus is placed on women-specific issues. As we have heard today, each one of those nearly one million people has their own story. Each has their own experience of our healthcare system, and we hear daily of their challenges and concerns when it comes to getting access to the right care at the right time. As Members have said, that includes getting timely access to GP appointments; specialised healthcare in rural areas; and getting a timely diagnosis, advice and information on female-specific conditions or symptoms to help make those informed choices. All of that can be compounded by ethnicity and socio-economic background and the additional barriers and inequalities faced by the most vulnerable groups of women and girls in our society. Members are right to outline the key elements that need to be considered in a women's health strategy to improve that provision and access to key services, including services for menopause, for gynaecological cancer screening, for cardiovascular health, for fertility and pregnancy, for baby loss and for postnatal healthcare, to name but a few. We know that, collectively, those issues cover the whole life course, so improving lifelong health experiences and outcomes for women also means better education and awareness from that early age. As has been said, it means learning about the importance of lifestyle and behavioural risk factors; the prevention of illness; living healthily; managing life changes such as menstrual health and menopause; living with health conditions; and knowing how and where to seek help when needed. For the health service, it is about making sure that that help is available and accessible. I fully acknowledge the challenges across all those areas, many of which have been highlighted by Members today. I am committed to addressing the issues for the women of Northern Ireland, and, while there are probably too many to cover in the time available, I want to mention a number of areas where I see opportunity for progress to be made. First, I want to prioritise the implementation of the recent Getting It Right First Time or GIRFT report to improve access to our gynaecological services. Our waiting times are simply unacceptable. The report, which was published last month as part of the work that my Department is taking forward under the elective care framework that I published in 2021, sets out recommendations to maximise our capacity, reduce those waiting times and improve patient care and outcomes. As Health Minister, I want to see those waiting lists come down to acceptable levels, and I expect to see real progress on those recommendations in the months ahead. My Department has now written to all trusts about the report and will engage with relevant stakeholders to progress implementation as far as possible with the available resources. It is recognised that some of those recommendations will require additional investment, and that will impact on delivery. I join colleagues in recognising the impact that the menopause can have on women, who will all go through that change at some stage in their life. I wore the MenoVest for a short time, and Linda Dillon expressed it well when she told me, straight to my face, "Now you know what it feels like". I wore it for only 45 minutes, and I encourage those in the Chamber who did not avail themselves of that opportunity to do so; they should. We are seeing the start of a welcome shift in societal attitudes and understanding of the menopause, and I believe that, as has been said, a new Executive can do much more to support that across all sectors.
Too many women are leaving the workforce early, as Kellie Armstrong said, including in the health and social care system, where the majority of staff are female. We know that changes in policy could make a huge difference to those individuals, their families and the wider economy. I stress that there are many examples of good practice in menopause care in our system. It is important to ensure that that is equitable and that best practice is standardised across the region. Mrs Dodds mentioned cervical cancer in her contribution. We have a very effective screening programme that has saved many lives over three decades. I was very pleased to see the introduction of full primary HPV screening into the pathway in December last year. Thanks to extensive planning by the Public Health Agency and the trusts, along with departmental officials, that brings our system into line with the rest of the UK by implementing the advice of the National Screening Committee and the Northern Ireland screening committee. That will use a test that is more effective at detecting women who are at risk of developing cervical cancer. That change will help in prevention and early detection, and will ultimately save more lives. I recognise that there are many people who long for a child and are desperate to hear when the current fertility service can be expanded to offer a second and, indeed, third cycle to eligible women. That is in line with the National Institute for Health and Care Excellence (NICE) guidance and with a commitment in the New Decade, New Approach agreement. During the pandemic, one of my priorities as Minister was to reinstate and stabilise fertility services as quickly as possible. I am pleased to say that the staff at our regional fertility centre have worked extremely hard to bring waiting times down to a level that is better than it was before the pandemic, with a first appointment wait of 23 weeks and new IVF and intracytoplasmic sperm injection (ICSI) patients currently waiting approximately two months. I thank the RFC staff for their hard work and dedication in doing that and for preparing the ground for an increase in provision once capacity can be increased. I congratulate Ms Mulholland on her maiden speech and look forward to working with her in North Antrim. She mentioned perinatal mental health. In relation to maternal mental health, each trust now has an operational community perinatal mental health team in place. Each team is accepting referrals and providing a consultancy service to women who experience mental health problems during the perinatal period. In addition, a regional implementation team has been established within the Public Health Agency. That team has been instrumental in leading the implementation of the community teams by having oversight and providing guidance. That ensures regional consistency, creating referral pathways and ensuring that our new service is fully integrated and embedded into existing services. In line with my Department's commitment to establish a mother-and-baby unit, as set out in our mental health strategy delivery plan for 2023-24, I can inform Members that the Belfast City Hospital site has been identified as the most suitable location, and that the Belfast Trust has been invited to prepare an outline business case for the provision of the proposed regional unit. However, delivery of that project remains subject to budget affordability, which, as Members know, has not been confirmed.
I concur with the Member's comments. I could say the same thing about many services across Health and Social Care. I therefore look forward to her encouraging her two ministerial colleagues to support my bids in the forthcoming Budget and in all the work that I want to do across healthcare, which includes the development and construction of a mother-and-baby unit, as I set out in the mental health strategy delivery plan for 2023-24. I could go on, as there are so many other women's health initiatives across primary care, social care, pharmacy services and allied health services, including hugely important areas such as maternal health, sexual health and pregnancy loss, which I do not have time to cover today. I hope, however, that I have assured Members that significant work in those areas is embedded in my Department's work programme as a priority. I am committed to providing greater focus and coordination on women-specific issues and to prioritising limited resources to where they will be most effective in my areas of responsibility as Health Minister. As I mentioned earlier, my Department is in the process of developing a short- to medium-term women's health action plan that builds on ongoing work and identifies the priority actions across women's health services that can be taken forward within our current budget, as well as those actions for which additional investment may be required. That will pave the way for a women's health strategy in the longer term. Crucially, as a part of that work, I want to listen to Northern Ireland women and hear their views on and experiences of the healthcare system and how it should be shaped. I welcome the fact that, as a society, we hear much more public discourse about women's health issues, and I commend the groups, charities and councils that are helping to bring about that positive shift. I also acknowledge the need for improved public awareness and information. We are working with the Public Health Agency to understand how best we can reach specific groups of women and girls and what that might look like.
I apologise, but I want to finish this. We must take note of the fact that awareness raising should go beyond the female population, in order to ensure that everyone has a better understanding of women's health issues and the wider impact that they can have, particularly employers. In conclusion, I assure Members that we have a strong foundation of work in progress that will form the key components of a women's health action plan. That work is in the early stages, so I cannot say when it will be finalised, but I hope to say more about that in the weeks and months ahead. By putting women at the centre of discussions, we can ensure that their voices are heard and that the limited funds are appropriately aligned with priorities. I am confident that, through the approach that I have outlined today —
— and the support of Assembly colleagues, we can improve health outcomes for all women and girls in Northern Ireland. I very much welcome today's debate and thank Members for their contributions. If Ms Dillon wants in briefly, I will give way.

2,123 words. Text as published by the Northern Ireland Assembly.

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