Thursday, 23 June 2022
Saincheisteanna Tráthúla - Topical Issue Debate
I thank the Minister of State, Deputy Noonan, for taking this matter. I ask him to outline the plans by the Department of Health for the introduction of the free contraception scheme for 17- to 25-year-olds, which is due to happen in August. I am seeking clarification as to whether it needs to be done by way of legislation or by means of regulation. If the former, when will we see the draft Bill and a timeframe for bringing it forward? My understanding is that it is not clear whether legislation or regulation is required.
My second point relates to engagement with GPs on the scheme. Are there plans to provide training for GPs, especially in respect of long-acting reversible contraceptives, LARCs? Has there been engagement with the Irish Medical Organisation, IMO, on the introduction of the scheme? Has the Department looked at the geographical spread of GPs available to provide support in the implementation of the scheme? Has there been engagement with the HSE on the scheme?
Are there plans afoot for the roll-out of a public information plan on the introduction of the scheme and, if so, when is that campaign likely to begin? An important issue to consider is that third level colleges will be coming back in the second or third week of September. Is the Government satisfied there is adequate support within the colleges in respect of the roll-out of the scheme?
It is important that we get this clarification now and that planning starts in respect of the information that must be disseminated to the public to ensure it will be available in a timely manner.
I thank the Deputy for giving me this opportunity to update the House on this matter, which is one of the Government's top priorities for action this year. The report of the working group on access to contraception, published in October 2019, identified the barriers that exist to accessing contraception. These barriers include accessibility, information, health system capacity and, for a significant number of women who may be just above the eligibility threshold for a full medical or GP visit card, cost. Following the recommendations of the Oireachtas Joint Committee on the Eighth Amendment of the Constitution and the findings of the Department of Health's working group on access to contraception, the 2020 programme for Government commits to providing free contraception for women, starting with those aged from 17 to 25.
The decision to prioritise this cohort was based on research, summarised in the working group's report, showing that women aged from 17 to 25 are most likely to experience a crisis pregnancy, and are also least likely to have independent financial means. A significant number of these women are still in full-time education and dependent on parents and guardians for income, some of whom may not be willing or, indeed, able to fund prescription contraception. The barriers to accessing the most effective forms of contraception are, for this cohort in particular, likely to be exacerbated by current inflation rates and the consequent rise in the cost of living.
The Department of Health's contraception implementation group was convened last year and has been working with partners, including the HSE, towards ensuring the scheme will commence in the third quarter of this year. Funding of approximately €9 million has been allocated for this in budget 2022. The scheme will provide for the cost of prescription contraception; the cost of medical appointments to discuss and prescribe suitable contraception; the cost of fitting and removal of long-acting reversible contraception, for example, implants and coils, plus any necessary checks; and the cost of training and certifying more doctors to fit and remove long-acting reversible contraception, such as the implant or coil. The wide range of prescription contraceptives currently available to medical card holders will also be available through this scheme, including contraceptive injections, implants, coils, the contraceptive patch and ring, and various forms of the pill, including emergency contraception.
The scheme will be open to all aged 17 to 25 who are ordinarily resident in Ireland. Formal contract discussions with medical representative bodies are ongoing with regard to service provision and the legal framework for the scheme is also being progressed. My response has probably answered two of the Deputy's three questions. I am not entirely sure about the third question on legislation and regulation, but I can come back to the Deputy on this.
I raise this matter because concerns have been expressed to me that there may be a need for legislation in the context of this scheme. In that regard, I am concerned about the timeframe we have to pass any such required legislation, with this House only sitting for another three weeks, and likewise with Seanad, which any Bill would also have to go through. The issue here is whether we need legislation. If we do, the problem will be that we may not be able to implement the programme and this scheme in August this year. Therefore, it is important that clarification is provided regarding this matter.
On the other hand, if it is not a matter of legislation, what progress has been made in respect of regulations? Again, regulations cannot be drafted overnight. It takes time to do that, and some support from a legal perspective as well. Where are we with this endeavour and when will we get a definitive answer from the Department on this matter? If we are still uncertain about the issue of legislation and regulations, how can we plan an information programme in the context of the implementation of this scheme? Therefore, some clarification is needed. I ask that the Department respond to me at a very early stage next week to confirm whether this scheme will be undertaken via regulations or legislation. If it is legislation, I would like clarification on the timeframe for bringing that forward and for introducing the Bill into this House.
My closing statement might provide clarification. The free contraception scheme for those aged 17 to 25 represents a wonderful opportunity to increase access to contraception and to better support sexual and reproductive healthcare in Ireland. We hope that the measures will significantly reduce crisis pregnancy rates among this high-risk cohort, who are also the most likely to experience cost barriers to accessing the most effective forms of contraception. The working group on access to contraception and the women’s health task force have, separately, conducted stakeholder engagement exercises in the last five years. The measure is enthusiastically supported by a large majority of stakeholders, particularly clinicians and others working in the area of women’s sexual and reproductive health.
Research conducted in England on the free contraception scheme in that country showed that it was extremely cost-effective and we expect that the outcomes here will be similarly positive. Given that the costs of prescription contraception are typically faced by women, the measures will have a significant positive impact on gender equality. Reducing costs for women will also benefit their partners and families. The scheme will also represent a reduction in the cost of living for those in this vulnerable age cohort who are sexually active and were not previously eligible for a medical or GP visit card. The Department is working hard on finalising the legislative framework and contract discussions with service providers prior to launching the scheme and hopes to be able to provide significantly more detail in the weeks to come.
I will get clarification for the Deputy on how the legislative framework is advancing and on the particularly important point around the information programme and rolling out an information campaign over the coming weeks and months. I will ask the Department to respond directly to the Deputy in this regard.