Ms Nicola Perry:

I thank the Deputy. I will come to that question in one moment but to return to her previous question that Mr. Keane addressed, when we are talking about policy barriers, he has addressed quite clearly where they lie and where they do not. Again, there is significant regional disparity. As I said, we do not really see it now, especially since doing this report, as urban versus rural but more Dublin and everywhere else, to be perfectly honest. It was a little more stark than we had realised before we started to do the research.

On the policy, the clinical guidelines for managing hepatitis C treatment are set by the clinical advisory group to the national hepatitis C treatment programme. To be clear, we are a member of the national hepatitis C treatment programme as the general oversight but as we are not clinicians, we do not sit on the clinical advisory group. They put a lot of policy and guidelines in place. Some were led by international best practice and some clearly were to fit the context of Ireland today but we had a lot of people who were waiting for treatment back in say, 2014 to 2016. The treatment landscape changed and became much easier to access and much more accessible. Many of those people, as Deputy Cullinane mentioned earlier, were those who had been impacted by the infected blood products and who had been infected through haemophilia treatment. They were treated quite quickly. They had all been waiting for treatment. The rest of the bulk of the people were those who had been infected through intravenous drug use, many of whom also were waiting and they were treated. There was this huge bulk and much policy was built around intravenous drug use, which on one level makes complete sense because it is the bulk of the numbers but then it excludes people who do not fall into that category. One of the biggest policy blocks we see and which is referred to frequently and on which we get feedback from patients is that if you are undergoing the services of an opiate substitute treatment, OST, programme and you receive methadone, your pathway to treatment is incredibly straightforward and simple-----