Concern over healthcare for poorer women

There is "without a doubt" an increase in undiagnosed sexually transmitted infections among poorer young women in parts of Dublin as the Well Woman and the Irish Family Planning Association turn away new medical card holders.

Chief executive of Dublin Well Woman Centres, Alison Begas, was speaking earlier today at the publication of the organisation's annual report, which also points to medical card holders being more likely to have abnormal smear tests.

Dublin Well Woman has centres in Ballsbridge, in the city-centre at Liffey Street and in Coolock.

Ms Begas said the Coolock centre, which has the highest proportion of medical card patients of the three Dublin centres, had had to stop taking new medical card holders in July last year, due to a fall in funding and an increase in card-holders.

"So we are turning away new, younger medical card holders and it is this age-group that has the highest rate of STIs, particularly chlamydia and genital warts.

"We know the IFPA is turning away new medical card holders too and I imagine a lot of GPs have closed their lists too. So where are these young women going?"

Asked how many had been turned away since last July she said the numbers were "definitely in the thousands".

"Without a doubt STIs are going undiagnosed among a significant proportion of these women."

Ms Begas said efforts to ensure poorer women have access to free smear testing under the national screening programme must be intensified.

Smear testing is crucial in the early diagnosis of cell changes likely to progress to cervical cancer.

Well Woman took about 60,000 smear tests between 2002 and 2008. The number of patients whose smears required further investigation peaked at seven per cent in the 25 to 29 age group at Ballsbridge.

In Liffey Street the rate was 6.7 per cent. On average, the rate was 9.5 per cent in Coolock. A disparity between private and medical card patients was notable, however. While 8.5 per cent of private patients required further investigation, 10.5 per cent of the medical card-holders did.

Ms Begas said the national cervical screening programme was under review and the introduction of online appointments was being considered, she said.

"Streamlining the programme should not in any way make it more difficult for poorer people to avail of screening," said Ms Begas.

"While online registration might be a useful tool in managing screening demand from the general pulation, many poorer women do not have access to a computer and - in some cases - do not have the skills to use one."

The report also showed a further increase in the number of women seeking emergency contraception.

Some 4,200 received it at the three clinics last year compared to over 3,700 in 2007.

The highest proportion of those seeking emergency contraception attended the Liffey Street clinic, which has a walk-in service at weekends.