I propose to take Questions Nos. 1790, 1796, 2111 and 2231 together.
As the Deputy is aware, there is a commitment in the Programme for Government to introduce a model of care for infertility. This model of care was developed by officials in my Department in conjunction with the HSE’s National Women and Infants Health Programme and will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary.
Phase One of the roll-out of the model of care has commenced and involves the establishment, at secondary care level, of Regional Fertility Hubs in maternity networks, which will facilitate the management of a significant proportion of patients presenting with infertility issues. Funding of €2m was provided to the HSE to commence Phase One of the roll-out of the model of care in 2020. This was utilised specifically in respect of the development of the first four Regional Fertility Hubs – namely, Cork Maternity University Hospital, the Rotunda Hospital, the National Maternity Hospital and the Coombe Women & Infants University Hospital.
Additional funding of just over €1m has been made available to enable the continuation of Phase One of the roll-out in 2021, including through the setting-up of the final two Regional Fertility Hubs, one to be located within the Saolta Hospital Group and one within the University of Limerick Hospital Group.
Phase Two of the roll-out will see the introduction of advanced infertility interventions including IVF, in the public health system. Phase Two will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated, and the assisted human reproduction (AHR) legislation is commenced.
The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
Our initial focus is to build up secondary level infertility services, which will give us a clear picture of the need for more advanced treatments (e.g. IVF) and enable us to establish the definitive funding requirement for same. When these services are developed and waiting lists for advanced AHR treatments established, my Department will be in a better position to estimate the demand for tertiary AHR services and the funding necessary to commence these services (taking note of access criteria and treatment packages for public funding).
While AHR treatment, such as IVF, is not currently funded by the Irish public health service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme.
Given the costs associated with certain fertility medicines, these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.