Dáil Éireann Debate, Thursday - 17 November 2022
311. Deputy Róisín Shortall asked the Minister for Health if he will provide an update on the six regional fertility hubs; the number that are open; the timeline that he is working towards for opening the remaining hubs; the treatments currently available in these clinics and the treatments which will be available once he has legislated for assisted human reproduction; and if he will make a statement on the matter. [57204/22]
View answerAs the Deputy will be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The Model of Care for Infertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary. This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF, and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways.Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking.There are five Regional Fertility Hubs currently operational, and these are located at Cork University Maternity Hospital, the Rotunda Hospital, the National Maternity Hospital, the Coombe Women & Infants University Hospital and University Hospital Galway. At this juncture, it is anticipated that the sixth and final Regional Fertility Hub will be in a position to be opened before the end of the year and will be located at Nenagh General Hospital, under the clinical governance of University Maternity Hospital Limerick. Therefore, the completion of Phase One of the roll-out of the model of care will result in fully operational Regional Fertility Hubs at six locations across the country.Phase Two of the roll-out of the Model of Care will see the introduction of tertiary infertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care.This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic. This is scheduled to open in the early part of 2024 and will provide a nationwide service, with all six Regional Fertility Hubs having equity of access for onward referral to it, via a shared care pathway. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.The 2023 allocation will also be utilised to support the Regional Fertility Hubs in order to expand their scope of services next year by introducing the provision of IUI (intrauterine insemination), a significant, yet less complex and less intrusive, component of AHR treatment. Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023. My officials, in conjunction with NWIHP, are now planning for the operationalisation of both the publicly- and privately- provided service, including the development of a national eligibility framework, as well as determining how the interim funding for private treatments will be provided to individual eligible patients. Overall, my Department and the Government is fully committed, through the full implementation of the Model of Care for Infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new 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.
