Assisted Human Reproduction

Dáil Éireann Debate, Thursday - 8 September 2022

Thursday, 8 September 2022

Ceisteanna (1628, 1869, 2077)

Mark Ward

Ceist:

1628. Deputy Mark Ward asked the Minister for Health the supports that are in place for persons trying to access IVF through the HSE; and if he will make a statement on the matter. [42468/22]

Cathal Crowe

Ceist:

1869. Deputy Cathal Crowe asked the Minister for Health the plans that his Department has to address the costs of IVF for individuals and couples trying to conceive. [43394/22]

Holly Cairns

Ceist:

2077. Deputy Holly Cairns asked the Minister for Health the date that he is working towards for the introduction of publicly-funded IVF and associated treatments. [44311/22]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 1628, 1869 and 2077 together.

The Government is committed to introducing a publicly funded model of care for fertility treatment as provided in the Programme for Government.

The model of care for infertility was developed by my Department in conjunction with the HSE 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 is envisaged before the end of this year.

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 has been required in respect of Part Two of the roll-out and, 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 needs to be completed.

This work will also need to be informed by the final Health (Assisted Human Reproduction) Act, the progress of this Bill – which has 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. As precursors to the development of this final part of the model of care, the priority has been to establish the necessary services at secondary level and to develop a regulatory framework, both of which are progressing well.

While advanced AHR treatment, such as IVF, 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 understand 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, or other advanced AHR treatment, privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.

Nevertheless, my Department and the Government is fully committed, through the full implementation of the model of care for infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced 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 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.