Anthony Lawlor (Fine Gael) | Oireachtas source

I thank the Cathaoirleach for allowing me to bring forward this Commencement Matter. I thank the Minister of State for her attendance. I know the Minister, Deputy Harris, is also quite interested in this subject. I raise the national roll-out of a free contraceptive scheme. Ready access to effective contraceptive care is a key part of good reproductive and sexual health for many citizens. Known barriers to effective access to contraceptive care currently contribute to the levels of unplanned and crisis pregnancies. These barriers include cost, particularly for women who are just above the threshold for primary care reimbursement service, PCRS, eligibility, younger women and adolescents. The latter group includes adolescents who may be eligible for services under the medical card scheme but who, for reasons of cost of attendance, confidentiality, particularly when they are on a family medical card, or ignorance - they may be unaware that they are eligible under a medical card scheme or can discuss the matter with their GP, practice nurse or pharmacist - are currently apprehensive about attending a general practitioner, GP, or family planning clinic. There is strong evidence that young people positively view GPs as reliable sources of health-related information but there are also deterrents to their accessing necessary advice and essential services.

The Government should cost and closely consider an improved and integrated primary care contraceptive scheme to provide better access to this key service which is highly relevant in reducing rates of abortion, the risk of unplanned pregnancies, the transmission of STIs and related anxiety among many women and some men of reproductive age in many Irish communities. There should be funding for an integrated primary care contraceptive scheme to increase the capacity of the primary care sector to deliver this essential service. An educational component to ensure that those who would benefit from an improvement in these services are aware and knowledgeable about when and how to access the services is also required. Such scheme would bring us into line with many European Union countries where such such services are largely free at the point of delivery to most EU citizens. It would also be consistent with long-standing Government policy on extending many free primary care services to many of our citizens. Reducing the number of abortions by means of an enhanced and expanded contraceptive scheme is particularly attractive at a time when medical abortions will become available through a process of constitutional change.

Schemes in regard to medical contraception and education should be considered. There are several problems relating to the knowledge and understanding of the population in terms of how and when to access and use these services. As part of the maternity scheme, participating GPs should be required to confirm that they have consulted with expectant mothers in regard to post-partum contraception. Adolescents should be advised that they are eligible to consult with their local pharmacist, practice nurse or GP for relevant services. As part of an integrated primary care contraceptive scheme, we should provide a related message service for secondary schools, as well as public health messages. The latter should include information on how to access relevant services, as well as clear messages that highlight high risk sexual behaviour, similar to the effective campaigns run by the Road Safety Authority. This aspect of the initiative would build on experience already gained, but it would be more powerful and sustained than previous campaigns on the topic.

At a community level, pharmacists, practice nurses and GPs who are interested should be enabled, encouraged and modestly supported to engage with local secondary schools. I also suggest school boards of management periodically invite interested practitioners to outline the services available and answer questions and inquiries made by students and school staff on relevant aspects of sexual health. Healthcare professionals who are assisting on this aspect of an integrated primary care contraceptive scheme could be engaged, supported and have their activities co-ordinated through high level agreements with their postgraduate training bodies and representative organisations.

Overall, an integrated primary care contraceptive scheme would be very welcome. As I said, we should take on board what the people demonstrated in passing the referendum. Of course, there will be crisis and unplanned pregnancies. We should provide support and consider introducing a scheme that will assist all of the people.