I propose to take Questions Nos. 866 to 871, inclusive, together.
The Report of the Working Group on Access to Contraception, published in October 2019, identified the barriers that exist to accessing contraception, which include accessibility, information, workforce capacity and, for a significant number of women who may be just above the eligibility threshold for a full GMS (medical) card, cost.
In consideration of the recommendations of the Joint Oireachtas Committee on the 8th Amendment to the Constitution (JOC8) and the findings of the Working Group on Contraception, the Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort.
Work on this was temporarily delayed by the Covid-19 pandemic, but the cross-disciplinary Contraception Implementation Group was set up in July 2021 to progress the introduction of this scheme.
The Contraception Implementation Group meets on a monthly basis, with meetings held in July, September, October, November and December 2021, and January 2022, with small sub-groups also meeting with counterparts in the HSE to ensure that steady progress is being made on implementation. Funding of approximately €9m has been allocated in Budget 2022 to enable commencement of the scheme, which is still scheduled for August 2022.
In terms of stakeholder consultations, it should be noted that the recommendations of the JOC8 took into consideration the deliberations of the Citizen’s Assembly on the matter. The Working Group on Contraception held a number of meetings with key stakeholders as part of its research, prior to publication of the Report.
More recently, my Department has held consultations and listening exercises with a large range of stakeholders, as part of the wider work of the Women’s Health Taskforce and, separately, as part of wider work to review the National Sexual Health Strategy. Clear stakeholder feedback with regard to access to contraception is duly taken into consideration in the development and progression of this scheme
The scheme will provide for:
1. The cost of prescription contraception;
2. The cost of two consultations per annum with GPs and other doctors to discuss suitable contraception for individual patients and to enable prescription of same;
3. The cost of fitting and/or removal of various types of long-acting reversible contraception (LARCs) plus any necessary checks, by medical professionals certified to fit/remove same;
4. The cost of training and certifying additional medical professionals to fit and remove LARCs;
5. Provision of contraceptive options currently available to GMS (medical) card holders through this scheme, to include contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.
For items such as the contraceptive pill, these are typically prescribed at 6 month intervals, so two consultations allows for full provision. For LARCs, (e.g. IUS, IUD, implants, injections, patches and rings), where the fittings/injections are carried out by healthcare professionals, fitting and removal appointments are also provided for separately, in addition to the two consultations.
Work on the legislative framework for the scheme is ongoing. Formal negotiations with medical and other relevant representative bodies with regard to service provision are due to commence in March 2022. The design of information and publicity campaigns to support and promote the roll out of the scheme will be finalised in the coming months.
With regard to the Deputy’s query about rolling out the scheme to wider age cohorts, the scheme for 17-25 year olds is being rolled out in line with the Programme for Government which stated the scheme would start with this age cohort. Expanding the scheme to further age cohorts can be considered once we have had a chance to monitor and evaluate the 17-25 year old scheme and ensure that it is working smoothly in terms of gauging and properly costing demand levels and ensuring sufficient numbers of medical practitioners are certified to fit and remove LARCs.
As part of the allocation of funding for the scheme that was provided for in Budget 2022, funds are being made available for additional training capacity with respect to certification of medical professionals to fit and remove LARCs. The HSE is currently working on preparing to roll out these additional training supports. As the planned LARC training is a service matter, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.