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.
Alison Begas, Chief Executive of Dublin Well Woman Centres, was speaking yesterday at the publication of the Centre’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 to stop taking new medical card holders in July last year, due to a fall in funding and an increase in card-holders.
“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 “definitely in the thousands.Without a doubt STIs are going undiagnosed among a significant proportion of these women.”
She said efforts to ensure poorer women access free smear testing under the national programme must be intensified.
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.
In her statement in the report, Medical Director Dr Shirley McQuade, said: “Over the years we have used the same laboratories and guidelines in all three clinics. There is remarkable consistency in referral levels for private patients across all three clinics.
“However this pattern varies in Coolock, where the patient base is a 50:50 mix of medical card-holders and private patients.
“The medical card holders are clearly at higher risk of having smear test abnormalities that require further investigation. This indicates a clear health inequality,” said Dr McQuade. “Well Woman would like to see the national cervical screening programme take this into consideration when planning any targeted campaigns.”
Ms Begas said the national screening programme was under review and the introduction of online appointments was being considered. “Streamlining the programme should not in any way make it more difficult for poorer people to avail of screening.
“While online registration might be a useful tool in managing screening demand from the general population, 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.
Ms Begas said she was also disappointed at the low proportion of women who attended for post-abortion counselling.
She said when she wrote in last year’s report she was critical of the fact there was no national sexual health strategy. “One year on we are still awaiting Government action in this respect.”
