Ms Geraldine Fitzpatrick:

If one has surplus embryos, one pays the clinic to store them for one. The support group is finding that people really do not want to be in that position anymore. They want the minimum treatment. If somebody has three children and suddenly they have six embryos being stored, it is a dilemma for them. Patients are obviously more informed now and they do not want that much medication used.

Some of the clinicians will point out that a patient who has paid almost €15,000 for three failed IVF treatments will want three embryos used in any subsequent treatment. In such circumstances, it is very difficult for a clinician to refuse the patient's wish and offer only two embryos on the basis that she is 37 years old. If the Government were to issue guidelines on these matters, nobody would be able to argue with a clinician's decision and the patient and clinician would be protected. We are not seeking detailed legislation, which appears to take forever to introduce, but short-term steps to regulate the area and solve immediate problems. We could then examine the models in place elsewhere in Europe to identify what works and does not work. My point is that we have not moved since 2005.
On the model in place in the United Kingdom, as with everything else, no health system is perfect. However, under the British system, treatment is funded to a certain level and patients can then pay more for additional services. This is probably a good model and while I am not an expert on the Human Fertilisation and Embryology Authority, HFEA, in the United Kingdom, I am sure the Department could examine what elements of the British system are suitable and could be applied here. As was noted, everyone has problems with money and trying to sort out a career. The United Kingdom system is a good model to adopt. It would be good if fertility treatment was in the universal health insurance basket.
In 2005, the Commission on Assisted Human Reproduction reported that Ireland did not have the basic elements in place, including guidelines for general practitioners and gynaecologists. For this reason, we must start at a basic level and put in place a structure that will support people who seek infertility treatment.
The figures on infertility are roughly the same here as the figures internationally. I was also asked what options are available here. I return to the issue of the vulnerability of the patient. Clinics A, B and C may each offer a menu of options. The HFEA guide in the United Kingdom provides information on what each clinic offers and applies strict rules in this regard. Transparent data are lacking here as we do not, for example, have a single website that sets out the services provided by the various clinics. Such information would be welcome.
I was also asked about multiple births and the long term picture for babies. While a study of children aged 0 to 5 years has been completed in Cork, its findings have not yet been published. Data are, therefore, available and the maternity hospitals are doing internal research but little of it has been published.
The issue of legislation was raised by several speakers. The priority is to issue guidelines and take simple steps.
Senator Crown referred to the public relations department of the Health Information and Quality Authority. The Human Fertilisation and Embryology Authority was established as a stand-alone agency but now collaborates with the Care Quality Commission to reduce costs. The reason we propose a role for the Health Information and Quality Authority is that HIQA has a structure in place and we do not want another stand-alone body established as that would create additional costs. We would like one agency to deal with all of these issues.
People contact the National Infertility Support and Information Group to discuss good news and bad news, for example, adverse events, and we are not in a position to deal with these types of issues. One can read horrific stories on websites such as rollercoaster.ie. As members will be aware, when a clinic closed earlier this year, people read about it on a website. The clinic's property, including embryos and tissue, was transferred to another clinic without any consultation with patients. We need a structure in place that protects everybody when adverse events occur.