Why closure of clinic a triumph


The Cork Family Planning Clinic, outrun by its own success, closed its doors to a grateful public in October, writes MARY LELAND

The label on my plastic folder says, “Family Planning Clinic 1975. Etc.” Sifting through the file, I find a clipping from The Irish Times of February 1975. It refers to the Cork Family Planning Clinic’s first premises at 8 Tuckey Street and to the statement by the then Catholic bishop Dr Cornelius Lucey, warning congregations throughout Cork that the doctor running the new service was “not a Catholic”.

Commenting on Dr Lucey’s admonitions, Donal Musgrave wrote: “The basic difference between the new clinic and the old marriage guidance centre is that Dr Lucey exercised a very strong influence over the latter, whereas he has no power in Tuckey Street.

“The test will be whether the need for a family planning service independent of any of the churches is stronger than the bishop’s edict to his flock and whether Dr Lucey’s rule is still absolute in Cork. One way or another, he has succeeded in putting the clinic on the map.”

And on the map it stayed until October 2012. Then, the Cork Family Planning Clinic, outrun by its own success, closed its doors to a public it has ensured can avail of reproductive health services elsewhere and easily.

Response to demand

That was the ambition of those first steps in Tuckey Street when the now retired obstetrician and gynaecologist Dr Edgar Ritchie, psychiatrist Dr Anne Schofield, the late Máirín Morrish and a small group of GPs and other supporters began the work of supplying response to a very obvious demand in the city.

In many ways, this was a humanitarian response; the practitioners were dealing with contraceptive requirements and restrictions all the time, their patients often afraid both of their husbands and of the church.

However, within a short time of opening, the husbands began to attend the clinic as well, and although up to the final weeks a prayer group kept vigil across the street from the premises, even the church has diverted its attention to other issues.

“The average family size in Ireland in the 1970s was seven children,” remembers Mary Cummins, the clinic’s managing director. “The clinic made such a difference in the last four decades to women in Munster and all our ancillary activities have been developed here to the highest professional standards. We have provided contraceptive training to more than a thousand nurses and have also been part of the family planning training module for UCC’s nursing faculty, as well as tutoring graduates up to MSc level.’

More than birth control

From the beginning the intended scope was much more than birth control and the clinic, begun with the support of the Irish Family Planning Association in Dublin, also developed as a centre of excellence for its cervical screening programme.

Its sexually transmitted infection service, psychosexual counselling, non-directive pregnancy advice and post-abortion follow-up were other necessary elements and the clinic, despite the early and daunting reluctance of the then Southern Health Board to recognise it for general medical services patients, has worked closely with the HSE, not least in the provision of the contraception section of the youth health service in Shandon Street.

“But that, as a comprehensive scheme tackling everything from birth control to nutrition, eventually led the younger clients away from us.”

Although the analogy may not be appreciated, it’s a bit like the closure of the convents: thinking back to an era when the condom was a furtive import and vasectomies a hard act to sell, the clinic has achieved its objectives and has been replaced by independent providers.

As Dr Ritchie puts it, “In a sense the service is very much with well-trained family doctors now – which is where we wanted it to be.” Looking back he also credits the fact that the clinic was started with the involvement of “wonderful people”, several of whom remained with it from beginning to end.

That’s a triumph, not a failure, although it’s easy to understand the sadness of those who worked with such dedication and for so long to see the doors close for good.

Despite its vocational ethos, the clinic has always had a pragmatic awareness.

Meticulous records

From her meticulous records, Cummins, who began here as a volunteer nurse, pulls the facts: a 48 per cent decline in the numbers of clients over the past 12 years cannot be argued with, nor can the financial implications of PAYE and PRSI regulations of 2010 and the increases in professional indemnity insurance.

Cummins talks about the early days as being similar to a war. In a sense it was, at first, with landlords reluctant to lease their premises because of the nature of the service.

What’s lost to Cork is the expertise and wealth of knowledge built up over 38 years in a service that always operated within the law. Research shows the lifetime of a provision such as this is usually 30 years and Dr Ritchie sees how that timespan makes sense. “It’s a service that has passed on now to others,” he says.

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