Dáil Éireann Debate, Wednesday - 18 May 2022
231. Deputy Niamh Smyth asked the Minister for Health the estimated full-year cost to develop a clear pathway of care from general practitioners for those with fertility concerns, including general practitioner--access to diagnostics where appropriate. [25134/22]
Amharc ar fhreagra233. Deputy Niamh Smyth asked the Minister for Health the estimated full-year cost to commit to four publicly-funded IVF cycles, including medication and mental health supports. [25136/22]
Amharc ar fhreagra236. Deputy Niamh Smyth asked the Minister for Health the estimated full-year cost to establish a publicly-funded one-stop-shop for surrogacy medical testing, including mental health supports. [25139/22]
Amharc ar fhreagraI propose to take Questions Nos. 231, 233 and 236 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 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. The completion of Phase One of the roll-out, envisaged before the end of this year, will result in fully operational Regional Fertility Hubs in each of the six Hospital Groups across the country.
Initial funding of €2m was assigned in order to commence Phase One of the roll-out of the model of care in 2020 and additional funding of approximately €1m was made available for 2021. These allocations were utilised to enable the setting-up of the Regional Fertility Hubs. According to figures updated by NWIHP in 2021, the total full-year cost of fully operating the six Hubs is estimated to be in the region of €2.87m.
Phase Two of the roll-out of the model of care will see the introduction of tertiary infertility services, including IVF, in the public health system. 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. This work will also need to be informed by the final Health (Assisted Human Reproduction) Act, the progress of this Bill – which has recently passed Second Stage in the Dáil – and associated regulations that will be developed following the enactment of this legislation. My officials are continuing engagement with the HSE in relation to the necessary programmes of work required to further advance consideration of the issues arising for commencing Phase Two of the roll-out of the model of care.
Finally, in respect of surrogacy services, Part 7 of the Health (Assisted Human Reproduction) Bill 2022 outlines the proposed circumstances under which domestic surrogacy will be permitted in Ireland. The proposed specific conditions include a requirement for all surrogacy agreements to be altruistic and authorised by the new Assisted Human Reproduction Regulatory Authority prior to the provision of AHR treatment. The surrogate mother and the intending parent(s) must have provided fully-informed consent to the surrogacy agreement, have received appropriate counselling specific to surrogacy, and the surrogate mother must have been assessed as being both physically and psychologically suitable to act as a surrogate mother. The scope of surrogacy related-services, if any, that may be incorporated into the model of care for infertility will be considered as part of the above-mentioned programmes of work.
