Dáil Éireann Debate, Tuesday - 29 November 2022
684. Deputy Colm Burke asked the Minister for Health when the consultation process will commence regarding the €10 million in funding allocated in Budget 2023 towards publicly funded IVF treatment; when full details of the scheme will be announced and made available; the way that this scheme will work in tandem with the Health (Assisted Human Reproduction) Bill 2022 when enacted; and if he will make a statement on the matter. [59092/22]
View answer717. Deputy Colm Burke asked the Minister for Health the discussions that have taken place with private fertility treatment providers and his Department with regards to the roll-out of publicly funded IVF treatment in Ireland in 2023; and if he will make a statement on the matter. [59433/22]
View answer718. Deputy Colm Burke asked the Minister for Health the consultation that has taken place with stakeholders with regard to the roll-out of publicly funded IVF treatment in 2023; and if he will make a statement on the matter. [59434/22]
View answer719. Deputy Colm Burke asked the Minister for Health the number of patients that access fertility treatment in Ireland each year; if the budget allocated for 2023 is adequate to address that need; and if he will make a statement on the matter. [59435/22]
View answer720. Deputy Colm Burke asked the Minister for Health when he envisages that Ireland will have a fully-funded public fertility treatment system; the expected cost and timeline for same; and if he will make a statement on the matter. [59436/22]
View answer736. Deputy Éamon Ó Cuív asked the Minister for Health the arrangements in place for persons who are living with and beyond cancer, whose fertility has been impacted by their treatment, to ensure that they will have access to publicly funded fertility treatments, such as IVF, as announced in Budget 2023; and if he will make a statement on the matter. [59515/22]
View answerI propose to take Questions Nos. 684, 717, 718, 719, 720 and 736 together.
As 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 Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related 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 (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) 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 fertility-related 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. At this juncture, it is anticipated that the sixth and final Regional Fertility Hub will be in a position to be opened in Q1 of next year. 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 fertility 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 historic 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.
Substantial planning, development and policy work is required to establish the scope, design and requirements for this component of the Model of Care. At this juncture, the design and scope of this aspect of the Model of Care have not been finalised as detailed consideration of a range of issues including service and treatment design, eligibility and access criteria, and associated resource implications is required, including the current provision of fertility preservation services for cancer patients.
My officials, in conjunction with NWIHP, are now actively 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. I expect that this process will involve, where appropriate, engagement with relevant stakeholder groups.
In respect of the Deputy’s query on the number of patients who access fertility treatment in Ireland, data from the Health Products Regulatory Authority, as published by the Library & Research Service of the Houses of the Oireachtas, indicates that a combined total of 9,878 IVF, IUI and frozen embryo transfer cycles were commenced in 2020. However, it should be noted that other jurisdictions which publicly provide or publicly fund, by whatever means and to whatever extent, AHR treatment all generally have some form of eligibility framework in place which restricts access to such treatment to patients who meet relevant criteria, such as in respect of, for example, age, BMI (body mass index) or medical indication.
As the Deputy will be aware, the Health (Assisted Human Reproduction) Bill 2022 passed Second Stage in the Dáil in March 2022 and has been referred to the Select Committee on Health for Third Stage. I am not in a position at this juncture to give a definitive timeline for the Bill’s complete passage through the Houses of the Oireachtas, nor its subsequent commencement. However, my officials will continue to undertake preparatory work in respect of the establishment of the AHRRA and I wish to reiterate my commitment to progress this much-needed and long-awaited piece of historic legislation to ensure that a robust regulatory framework for AHR is in place as quickly as possible.
Overall, my Department and the Government is fully committed, through the full implementation of the Model of Care for Fertility, 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.
