Women lobby for access to gynaecological care

Women with serious gynaecological problems including incessant bleeding, fibroids and painful sexual intercourse are increasingly turning to their GPs and TDs to lobby for them in a desperate bid to access treatment at Cork University Maternity Hospital (CUMH).

The Irish Examiner has seen a range of anonymised letters where doctors and politicians are pleading on behalf of women for intervention. They include a case where a woman has waited since 2014 for a robotic hysterectomy; a case where a woman with fibroids and vaginal bleeding had been bleeding for more than two weeks, and a case where a woman was experiencing worsening symptoms of dyspareunia (painful intercourse).

In response to a TD who wrote seeking help for one of his constituents, management at CUMH advised that because she had been triaged as “routine” she would be waiting “at least” 129 weeks for treatment.

The ongoing delays besetting gynaecological services at CUMH are reflected in the astronomical waiting lists, where latest figures from the National Treatment Purchase Fund (NTPF) show outpatient figures continue to increase despite promised intervention by Health Minister Simon Harris.

February figures show 4,349 women on the outpatient waiting list, up from 4,193 last November, when the issue was highlighted in this newspaper — in the wake of which Mr Harris promised action to tackle the lists. The number of women waiting more than 18 months has also climbed, from 817 last November to 921.

Almost the entire consultant cohort at the hospital took the unprecedented step of writing to their CEO, Tony McNamara, last year, to warn they would no longer take responsibility for the deteriorating health of women on the waiting lists.

At the time, chair of the Institute of Obstetricians and Gynaecologists, Dr Peter Boylan, said Mr McNamara had “lost the dressing room”.

They warned that women waiting excessive times for treatment faced the possibility of delayed cancer diagnosis.

The consultants have repeatedly asked for investment in the service, including additional theatre time and access to an additional theatre; four additional consultant obstetrician/gynaecology posts; a gynaecology day unit and a gynaecology one-stop shop.

Following a visit by Mr Harris to the hospital in January, consultant obstetrician/gynaecologist Professor John Higgins was appointed clinical director of maternity services for the South/South West Hospital group with delegated responsibility for budget.

Mr Harris also committed at the time to meet with the consultants in 4-6 weeks to hear their proposals for tackling the waiting lists. The meeting was scheduled to take place yesterday but has now been pushed back to the end of March.

Consultants reacted angrily and said the date change was effectively adding to waiting times because patient appointments, already rescheduled to facilitate yesterday’s meeting, would have to be re-scheduled again to allow them meet with the minister on March 30.

Catalogue of delays

Extract from a letter written by a GP on behalf of patient waiting for a robotic hysterectomy since October 2014:

“She has a very large fibroid measuring over 10cm which has increased in size since. She has ongoing problems with bleeding… I would be grateful if you could arrange for her to have her surgery as soon as possible.”

Extract from GP referral letter requesting urgent appointment:

“Reason for referral: Vaginal bleeding/fibroids… she is permanently bleeding for more than two weeks.”

Extract from GP referral letter:

“X was referred [last year] with dyspareunia (painful intercourse). She continues to attend with worsening symptoms… If there is anything that can be done to expedite her appointment we would greatly appreciate it.”

Response from CUMH management to TD who asked that a constituent be seen ASAP:

“There are in excess of 400 patients ahead of her… the current waiting times are in excess of 129 weeks and therefore unfortunately X will be waiting at least this time.”

Extract from a GP letter requesting that patient’s treatment be expedited:

“She complains of pain and swelling… She had an ultrasound done showing a possible endometrioma (type of cyst)...”