their children really needed to attend because they could not pay.  Twenty-six women answered yes for themselves only, while four had had to avoid going to the doctor even when their children needed to be seen.  It can only be assumed that these women did not have a medical card - with 58 women in possession of the medical card in this survey, this finding means that more than half of the other women and/or their children are being denied necessary medical care due to lack of money.  This unacceptable situation requires urgent attention - it is time to listen to women's voices and extend the medical card coverage NOW.

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Figure 19.  Pie Chart illustrating percentage responses to the question "Have you ever not visited the doctor when you or your child/children really needed to because you could not afford to pay" (N = 100).

10.4 Women have their say: On avoiding the doctor

Separated woman:
"When [I] was married, [I] had no medical card and both myself and [my] husband didn't go to the doctor when we really had to because we couldn't afford to pay."

Mother, age group 31-40, with medical card:
"[We] go to the chemist first, so as not to abuse the medical card"

Woman, 31-40 age group:
"Not so much because you couldn't afford it, but [we] think twice when paying €30 - not as quick to run as if it was free"

10.5 Satisfaction with Local Medical Services

Question 44 sought to establish the level of satisfaction with provision and availability of medical services locally - the responses are graphically illustrated in the Pie Chart in Figure 21.  More than half of the women surveyed were unhappy with medical services in their area, with 27% "Somewhat dissatisfied" and 24% "Very dissatisfied".  Only 15% were very satisfied with the care they were receiving.  The huge number of spontaneous comments made on foot of this question gives some indication of the reasons for this dissatisfaction (see a representative sample in Section 10.6). 

Many of the negative remarks related to NowDoc, the out of hours GP service that was recently introduced in Inishowen.  While some of these concerns may have arisen due to confusion and a lack of appropriate information, it is clear that the women did not like or trust the service.  If it is indeed here to stay in Inishowen, the North Western Health Board and the staff involved need to tackle the adverse public perception with a massive public relations campaign, especially in terms of information.  Finding out how the system works and how to use it effectively is not something women want to discover in the middle of a medical emergency (see also Section 12.7 in the final chapter).