Dáil Éireann Debate, Tuesday - 2 November 2021
927. Deputy Johnny Mythen asked the Minister for Health when legislation and availability of supports regarding assisted human reproduction such as IVF and surrogacy both domestically and abroad will be made available; and if he will make a statement on the matter. [52491/21]
Amharc ar fhreagraAs the Deputy will be aware, drafting of a bill on assisted human reproduction (AHR) and associated areas of research is ongoing by officials in my Department, in conjunction with the Office of the Attorney General. This legislation encompasses the regulation for the first time of a wide range of practices undertaken in this jurisdiction, including domestic altruistic surrogacy.
The surrogacy provisions of the Bill outline the specific conditions under which surrogacy in Ireland will be permitted, including a requirement for all surrogacy agreements to be pre-authorised by the new AHR Regulatory Authority. The legislation also sets out a court-based mechanism through which the parentage of a child born through surrogacy may be transferred from the surrogate to the intending parent(s).
Publication of the AHR Bill is a priority for my Department and the Government, and a commitment to enact this legislation is included in the Programme for Government, “Our Shared Future”. This Department will continue to engage intensively with the Office of the Attorney General in order to finalise this complex legislation.
The draft Bill does not contain provisions to regulate surrogacy arrangements undertaken in other jurisdictions. Issues which arise from the undertaking of surrogacy arrangements in other jurisdictions concern areas of law that intersect across the remits of several Government Departments and require detailed examination. My Department is engaging with the Department of Justice and the Department of Children, Equality, Disability, Integration and Youth in respect of these matters.
On the matter of supports available for AHR treatment, although 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.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
Further to this support, a commitment to introduce the model of care for infertility, which was developed by officials in my Department in conjunction with the HSE’s National Women & Infants Health Programme, is included in the Programme for Government, “Our Shared Future”. 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 as part of the full range of services available in obstetrics and gynaecology.
The 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). Structured referral pathways are being put in place and patients referred onwards for further investigations or treatment as required and as clinically appropriate.
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 the six Hospital Groups across the country, in order to facilitate the management of a significant proportion of patients presenting with infertility issues.
Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system, but will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated and the AHR legislation commenced.
The underlying aim of the policy to provide a model of funding for AHR, within the broader 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.
