Dáil Éireann Debate, Tuesday - 13 June 2023
1161. Deputy Róisín Shortall asked the Minister for Health if his attention has been brought to a campaign (details supplied); the steps being taken to improve access to male infertility services and address stigma surrounding the condition; and if he will make a statement on the matter. [27561/23]
View answerI thank the Deputy for drawing my attention to this campaign.
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 for both males and females, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking.
There are currently five out of six Regional Fertility Hubs in service and the completion of Phase One of the roll-out of the Model of Care, envisaged for later this year, 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 and is scheduled to open in 2024. 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 is also being utilised to support the Regional Fertility Hubs in order to expand the scope of services by introducing the provision of IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive, type 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 continuing to actively prepare for the operationalisation of both the publicly- and privately- provided service, including finalising access criteria and determining how the interim funding for private treatments will be provided to individual eligible patients. The design and scope of this final phase of the Model of Care for Fertility have not yet been finalised, but I am hopeful to be in a position to provide more specific details shortly.
In terms of GPs making referrals to the six Regional Fertility Hubs – which will in turn be clinically responsible for making onward referrals for AHR treatment as clinically indicated – GPs can make such referrals in relation to couples who may be struggling to conceive for a defined period of time and/or individuals who have a medical condition/history which is known to adversely impact fertility. Males with Klinefelter Syndrome who are struggling to conceive with their partner may therefore have access to Regional Fertility Hub services under either of these criteria depending on their knowledge or otherwise of their genetic condition at the point that they are trying to conceive with their partner.
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.
