Dáil Éireann Debate, Tuesday - 15 September 2020
90. Deputy Neale Richmond asked the Minister for Health the status of publicly funded fertility care as promised in the programme for Government; the form of supports that will be available; and if he will make a statement on the matter. [23278/20]
Amharc ar fhreagraAs the Deputy is aware, a commitment to introduce a model of care for infertility, details of which had been announced in December last year, is included in the Programme for Government. This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary. It will comprise 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). Structured referral pathways will be put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate. It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years.
Phase One of the roll-out of the model of care involves the development of Regional Fertility Hubs at secondary care level. Funding of €2m was provided to develop these Hubs in maternity networks which will facilitate the management of a significant proportion of patients presenting with infertility issue.
Phase Two will see the introduction of tertiary infertility services, 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 and the AHR legislation is commenced. Drafting of the AHR legislation is ongoing in conjunction with the Office of the Attorney General.
Substantial progress has been made in respect of the development of the Regional Fertility Hubs, and specifically the development of the first four of these Hubs. This is despite the work having to be slowed due to the management of the Covid-19 pandemic by the health service broadly and its impact upon the provision of elective health services, including fertility services.
It should be noted that while AHR treatment 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, I am aware that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
Overall, the implementation of the model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.
