Thursday, 10 October 2019

Questions (11, 72)

Mick Barry


11. Deputy Mick Barry asked the Minister for Health if he will report on the implementation of the recommendation by the Oireachtas Joint Committee on the Eighth Amendment of the Constitution for the availability of free contraception; and if he will make a statement on the matter. [41358/19]

View answer

Richard Boyd Barrett


72. Deputy Richard Boyd Barrett asked the Minister for Health if he will report on the implementation of his plans to provide free contraception; and if he will make a statement on the matter. [41365/19]

View answer

Oral answers (6 contributions) (Question to Health)

I heard the Minister mention earlier that he would have a contraception report in the next few days and perhaps it is timely to ask him to report on the implementation of the Oireachtas Joint Committee on the Eight Amendment of the Constitution for the availability of free contraception. I look forward to hearing his comments on that matter.

I propose to answer Questions Nos. 11 and 72 together.

Deputy Barry was up early this morning as well. I thank him for his timely question regarding contraception. I reiterate on the record of this House my view that we need to make contraception free for all women in our country. We have made very significant progress regarding male contraception in terms of condoms. We have very significantly increased the amount of condoms being distributed. We are putting vending machines into a number of locations throughout the country and our sexual health strategy very much aligns with this both in terms of reducing crisis pregnancy and in terms of reducing sexually transmitted infections, STIs, which are at a worrying level in our country.

The question of access to contraception is an important one. That is why, following on from the recommendations of the Joint Committee on the Eighth Amendment of the Constitution, I established a working group within my Department to examine the range of policy, regulatory and legislative issues because there are issues in each of those areas which arise with respect to improving access to contraception. I established the group in April and it has overseen a public consultation exercise. It received many public submissions and submissions from stakeholders. It has undertaken a review of research and met a number of stakeholders directly. I am pleased to say the group has just finalised its report and it has submitted to me in recent days for consideration.

It goes without saying that I intend to fully consider the detail of the report but, in doing so, I do not intend to sit on it. I would like to publish it and will do so this month. It might be very helpful for the Joint Committee on Health to see it also and to be able to consider some of these issues. We know, however, that there can be barriers to accessing contraception and that cost can be an issue. Most forms of contraception, including long-acting reversible contraceptives, LARCs, are provided free of charge to those with medical cards, so we are not starting from a point of nobody having free access. Many people already have free access to contraception. I have already mentioned the national condom distribution service, which supports free access to contraception among those who may be at increased risk of negative sexual health outcomes. The working group examined other means by which the costs involved in accessing contraception can be reduced and it has come up with a range of recommendations as well.

I intend to publish the report shortly. I suggest we will have a body of work to do in terms of legislation and policy options and we should get on and do that.

The Minister stated that the report will be published in the month of October. I would have liked to seen it published before the announcement of budget rather than after it, which brings me to my first supplementary question. Has the Minister made provision in the budget arrangements for 2020 to provide the funding necessary to provide free contraception for all in this State in the year 2020. As he is aware, Ireland is an outlier in terms of maintaining a cost barrier for women to have access to contraception. I am sure he will agree that the sooner that cost barrier is removed the better. Is there funding in the budget to provide free contraception in this State in 2020?

I agree with the Deputy that it would have been useful to have the report published in advance of the budget. However, I remind the House that we are framing a budget in the context of a no-deal Brexit where there is a range of priority issues we needed to address, including making sure we address home care services, mental health services and a number of other issues that have been raised in this House this morning. When people see the report, I think it will become very clear to the Deputy that if we as an Oireachtas were to press "go" on this, and I hope we do, much of 2020 would be taken up with the need to legislate in this area, as well as the need to engage with the healthcare professionals involved. They may need engagement regarding fees as well. I suggest that the cost in 2020 would be minimal because, if we are being honest with each other, this will really arise as a 2021 issue, but I would like this Oireachtas and Government to set the policy direction shortly. I would like to publish the report this month.

The Deputy referred to our county lagging behind in this area. The European contraception atlas for this year ranked Ireland 12 of 46 countries and gave the Government a rating of 65% for our policies and access to contraceptive supplies, family planning counselling and the provision of online information on contraception, so we are making progress in this regard. A third of our population hold a medical card. That means 124,379 clients availed of contraceptive drugs and special services through the General Medical Services, GMS, scheme last year.

My view is that it would have been best if we had free contraception available in 2020. I take it from the Minister's reply that is not the intention of the Government. He seemed to indicate it is his intention for 2021. Specifically, is the Minister saying that he aims to see the introduction of free contraception in this State in 2021? I ask him to comment on that. Currently, in terms of free contraception, there are prescription costs and GP fees. GP fees and prescription costs need to be removed from the equation. It should not be necessary to go to a GP to get a prescription to avail of contraception in many cases. Is it a definite aim to have free contraception in 2021? What about the question of GP fees and prescription costs?

My position on this is not in any way ambiguous. I signed up fully to all the recommendations of the Joint Committee on the Eighth Amendment of the Constitution and applied rigour to trying to progress a number of them working across this House and I will continue to do so. I believe contraception should be free for men and women. We should talk about men as well. It is not just a woman's issue. Men obviously have a role to play in reducing crisis pregnancies and in helping around these issues as well. We have made progress on the national condom distribution service this year.

When it comes to the female side of contraception, it will require dealing with regulatory issues, legal issues, policy issues and, possibly, fee negotiation. When the report is published, and it will be published this month, I will be very happy to debate it in this House and to talk about it at the health committee. It is my policy objective to make contraception free in 2021 and that is what I would like to see happen.

The Deputy talked about our record on some of these issues. We are also making PrEP available from 4 November. These are real, concrete steps that are taking place in regard to sexual health in our country. When it comes to female contraception, a woman's choice will be important because, as the Deputy knows, there are a variety of methods available.