Ms Geraldine Fitzpatrick:

I thank the Chairman and members for giving us the opportunity to speak on behalf of people who have difficulty conceiving. We sent the committee a submission, which I will go over very briefly. The National Infertility Support and Information Group, NISIG, was established in 1996 by three people, including myself. In 2005, the report of the Commission on Assisted Human Reproduction was published and we had a representation on that commission. We were established in 1996 and, nine years later in 2005, we took part in the commission and, nine years later in 2014, we are here, so we are probably making a little bit of progress, which has to be welcomed.
Unfortunately, the whole area of infertility is still very unregulated. The unmet needs we have are as follows. We need equal access for everybody, regardless of income, and we need independent governance and regulation of assisted human reproduction services in Ireland. As a consequence of that, we would get robust, independent and Irish-specific data which people should be able to access when they want treatment. Currently, they cannot do so and must go to the websites of all service providers to find out what services they provide and where. We believe that if these unmet needs are met, the patient, the clinician and Exchequer funds will be protected.
The population of Ireland is 4.5 million and one in six people are affected, but not everybody will seek infertility treatment. The pie chart in the submission shows that approximately 7,800 different types of treatment are carried out in Ireland annually, including IVF, intracytoplasmic sperm injection, ovulation induction and intrauterine insemination. We have included the websites of the different IVF clinics because people use social media and do their research on the Internet.
We also refer to the Human Fertilisation and Embryology Authority, HFEA, in the submission. We usually refer to UK governance when talking about infertility. The HFEA issues its report annually and was established in 1991. In recent years, it set up a new maximum multiple birth rate of 10% and it believes it has achieved that. We do not have any independent data which tell us what the Irish multiple birth rate is from IVF, but an audit on high-order multiple pregnancies in three Dublin hospitals was published in the Irish Medical Journalin January of this year. Between 1999 and 2008, 101 high-order multiple pregnancies were recorded. We also included the ESRI statistics in the submission because singleton births have reduced the stay in hospital by 16% from 2003 to 2012 whereas multiple births continue to have a high stay in hospital. We believe that some of those multiple births are probably caused by infertility treatment and if Ireland decides to have a target of reducing multiple births, it will reduce the cost to the Exchequer.
The report of the Commission on Assisted Human Reproduction was published in 2005 and the recommendations are exactly what we are looking for, which is a regulatory body, national statistics, the availability of counselling and the availability guidelines for general practitioners and gynaecologists. We believe our needs are in line with the commission's recommendations.
The White Paper on universal health insurance states that health care will be available based on need and not on ability to pay. Therefore, we hope assisted human reproduction technology will be included in that in order that people can get access to it. The problem with infertility treatment in Ireland is that it is quite an expensive treatment so, therefore, it is only available to those who can afford to pay. Some people travel abroad to have it in countries where it is less expensive but that causes problems because the patient is vulnerable as a result of having to travel abroad. Nobody really knows who is responsible for the patient's treatment.
The White Paper on universal health insurance states that the universal health insurance landscape will include a number of regulators, including the Health Information and Quality Authority, which will deliver good governance and good quality. We believe our needs fit into the UHI model which the Government proposes. What NISIG wants is the recognition of infertility as a health need. It needs to be addressed under the UHI model and good governance will actually save the Exchequer money in the long term as a result of fewer adverse events and fewer multiple births. There is a benefit for everybody.