Inequality of healthcare for women must be eradicated
Opinion:Today, Anand Grover, the UN special rapporteur on the right to health, is visiting Ireland to give the keynote address at a conference of the Women’s Human Rights Alliance. As a renowned advocate for women’s right to health, he is aware that there are many barriers when it comes to the realisation of this right for women in Ireland.
He will have heard already that we have a highly inequitable two-tier health system which offers privileges to those who can afford private health. The 48 per cent without private health insurance have to wait longer to access hospital and specialist services.
Women are particularly affected by this inequality. They are more likely to be poor, to parent alone, to be the main provider of unpaid care work, to earn low wages, and to be in poorly protected employment. Indeed women have identified lack of income as the main barrier to improving their health.
There are also significant health inequalities between different groups of women such as those with disabilities and those belonging to an ethnic minority.
Women with disabilities are likely to be trapped in a violent relationship longer than non-disabled women and, for some, such violence is the cause of the disability itself. Traveller women live 12 years less on average than settled women.
Furthermore, women are largely absent in the rooms of power when it comes to deciding on health policy. The lack of women’s representation in key decision-making bodies within the health system has serious implications for the quality of healthcare received.
Women and men have different health needs and health experiences. For example, women and men present different symptoms in relation to cardiovascular disease.
In the area of mental health, women are more likely to suffer from anxiety or depression, whereas men are more likely than women to die by suicide and less likely to seek help when experiencing mental distress.
Sexual abuse and violence against women has an appalling impact on women’s health – both physical and mentally. Some 42 per cent of women in Ireland experience some form of sexual abuse or violence over their lifetime.
More recently there have been positive developments towards a more gender-sensitive healthcare system. The National Women’s Council together with men’s groups and the Health Service Executive have worked together on an important report called Equal but Different which considers the differences between women and men’s health needs and how they can be integrated into the ongoing reforms of the health system. This framework will now be translated into a policy of the HSE and become part of its service plans. Pilots will be rolled out next year in the area of mental health and primary care.
No discussion on women’s right to health in Ireland in 2012 can take place without emphasising the critical right of women to reproductive health and abortion. The National Women’s Council of Ireland has long campaigned for reproductive rights in Ireland, with motions being passed by the membership over the last 20 years. The council has been to the forefront in our online campaign Legislate for X which has led to over 72,000 emails to TDs from over 16,000 people in every constituency in Ireland.
The tragic death of Savita Halappanavar has woken the country up to the risk to life for women in Ireland. The analyses and the range of opinions expressed by doctors and the testimonies of women in response to Ms Halappanavar’s death highlight the lack of clarity that confronts doctors and pregnant women.
Grover highlights in his ground-breaking report on abortion in 2011 that the right to sexual and reproductive health is a fundamental part of the right to health: “Criminal laws penalising and restricting induced abortion are the paradigmatic examples of impermissible barriers to the realisation of women’s right to health and must be eliminated.”
Today is the second anniversary of the A, B and C vs Ireland judgment. Women in Ireland cannot wait any longer. The Government must finally act and legislate for the X case. This must include as a minimum and first step the repeal of the completely outdated Offences against the Person Act 1861 which criminalises abortion in literally all circumstances.
The programme for government lays out radical plans for the reform of our health services including the introduction of universal health insurance and a new governance and organisational structure. This is to be welcomed.
However, the draconian funding cuts to the health budget over the past few years have resulted in wider health inequalities and poorer access to essential services. This is particularly affecting women living in poverty and disadvantaged communities, lone parents, older women, women with disabilities and people living in rural and isolated communities. Continuous cuts to our health services have had a detrimental impact on essential frontline services and seriously undermine the possibility of the reform programme being implemented in the foreseeable future.
While acknowledging that the current economic crisis is a challenge, the National Women’s Council also sees it as an opportunity. The council and many women’s groups argue that this is a unique time to gender-proof all reform proposals, ensuring that they are effective and make the best use of existing resources.
Today on the occasion of the UN special rapporteur on the right to health’s visit, we call on the Government both legislate for the X case and ringfence funding to deliver on promised health reforms.
In times of austerity, the health of women and indeed the entire population should not be compromised.
* Orla O’Connor is director of the National Women’s Council of Ireland, which convenes the Women’s Human Rights Alliance