Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I am delighted to be here. It is a good day in terms of legislation, women's healthcare and the cost of living as it relates to healthcare. The Bill's core purposes have been expanded. Originally the Bill had one aim, namely to abolish inpatient charges for children in hospitals. That is a really important step in the right direction. It is now being amended to encompass provisions to provide free contraception on a statutory basis in the State for the first time.We are starting the scheme with women aged 17 to 25, as per our commitment in the programme for Government.

I will first focus on the initial objective of abolishing public hospital inpatient charges for children. This legislation, when enacted, will ease the financial burden of parents and guardians when bringing their child to hospital for inpatient care. It will help to ensure that cost is not a big consideration for families when children require access to inpatient treatment. Currently public patients, including children, are subject to a statutory inpatient charge of €80 per day, up to a maximum of 10 days, or €800, in a year. This Bill seeks to put an end to that charge for children. It will amend the Health Act 1970 to provide a specific additional exemption from this charge for children under the age of 16.

This is an important step towards affordability, along with a lot of other things we are doing. We have reduced the drug payment scheme. We are looking at free GP care for six- and seven-year-olds. The two provisions in this Bill are really important. It is an important signal. If parents or guardians have a child in hospital then they are already going through a very difficult time and are already under a huge amount of pressure and stress. Having brought their child to hospital and having had their child in hospital for ten days or more, the last thing that parents then need is a bill from the hospital for €800. This legislation will put an end to that, which is very welcome.

Following a recent Government decision, a Dáil Committee Stage amendment was brought forward to the Bill to provide for free contraception, starting with women aged 17 to 25. As we discussed here previously in the Seanad, the intention is to expand that scheme. We want this free contraception available for everybody. We must start somewhere and the expert report we got back proposed that we start with 17- to 25-year-olds. The scheme will be open to all women aged 17 to 25 who are ordinarily resident in Ireland. The scheme will fully cover all of the costs associated with it including medical appointments to discuss and prescribe suitable contraception; fitting and removal of long-acting reversible contraception, LARCS, for example, implants and coils; any necessary checks for LARCS; and a wide range of prescription contraceptives currently on the reimbursement list and available to medical card holders. It also will abolish the prescription charges for medical card holders for other medicines. It is very wide ranging in the context of the costs it covers. A woman can go to the doctor, have a consultation for implants for long-acting reversible contraception or for the pill or other prescribed medicines, have check-ups and get the medicines or devices, all of which costs will be covered.

I will now provide a brief explanation of the sections of the Bill. Part 1 contains standard provisions setting out the Short Title citation and provides that the Bill shall be subject to a commencement order.

Part 2 of the Bill deals with exemptions from public inpatient charges for acute inpatient services.

Section 3 amends section 47A of the Health Act 1970 to provide that the new section 53C(9)(bb) of the Health Act 1970, which gives effect to the exemption from charges for acute inpatient services for children under the age of 16, is included for reference within section 47A of the Health Act 1970.

Section 4 amends section 53C of the Health Act 1970. Section 53C provides that charges shall be made for acute inpatient services provided by or on behalf of the Health Service Executive. The proposed new section 53C(9)(aa) confirms that the €80 public charge is not applicable to persons who have chosen to avail of private acute inpatient services under section 55 of the Health Act, in which circumstances the more significant charges set out in Schedule 4 appropriately apply.

The proposed new section 53C9(bb) provides for the exemption from the charge for children up to the age of 16 years of age arising from acute inpatient services. The Bill also provides that under sections 4(c) and 4(d), the existing inpatient charging exemption provisions for children will not be impacted. The big effect of these amendments is to remove the acute public inpatient charge of €80 per day for children under the age of 16 in all public hospitals.

Part 3 deals with the provision of contraception services. Section 5 amends section 47A of the Health Act 1970 to provide that the new section 67E of the Health Act 1970, which gives effect to the free contraception scheme for women aged 17 to 25, is included for reference within section 47A of the Health Act 1970.

Section 6 inserts a new section 67E into the Health Act 1970. This contains the main provisions for the free contraception scheme. Within this proposed new section 67E, there are 11 subsections. I will briefly focus on some of the main subsections. Subsection (1) provides that the HSE will make available, without charge, access for women aged 17 to 25 to medical practitioners for the purposes of accessing prescription contraception, dispensing of prescription contraception by pharmacies and the fitting and removal of long-acting reversible contraception, and that this will be free of charge. Subsection (2) provides that a woman can choose to access the scheme through any GP or medical practitioner who has signed up with the HSE as a scheme provider. Subsection (3) provides that free prescription contraception will be accessed via pharmacies. Subsection (5) provides that the Minister, after consultation with the Minister for Public Expenditure and Reform, may make regulations to vary the age cohort eligible for the scheme, allowing for wider access in future, which we hope to do.

Subsection (6) provides that the age cohort cannot be extended below the age of 17 years by way of regulation. This point came up on Committee Stage, and indeed we spent all our time in Dáil Éireann on this point during Committee Stage. This subsection is included in order for us to get the Bill passed. It is not my intention that this would remain as a permanent feature in the Bill. I have asked the Department to start preparing the amending legislation. We received legal advice recently that we needed to put the scheme on a statutory basis. It is important to me, and I believe to colleagues here, that this happens before the Dáil rises for the summer recess. We want the scheme in place and operational at the end of August and the start of September. I believe the scheme should be expanded to those below the age of 17. The only reason this subsection is here is to make this Bill, which was put together quickly, legally robust. The Department will now be spending the time on some of the real complexities in terms of reducing the age to below 17. I am fully committed to doing that.

Subsection (7) provides that the Minister, with the consent of the Minister for Public Expenditure and Reform, may set the fees to be paid to GPs and pharmacists under the scheme.

Section 7 of the Bill contains a number of consequential amendments to Health (Pricing and Supply of Medical Goods) Act 2013.

In summary, bearing in mind all of the positive impacts arising from the abolition of public inpatient charges for those under the age of 16, and the introduction of the contraception scheme, starting with women aged 17 to 25, I am seeking the support of Seanad Éireann for these very important affordability measures. I believe they are beyond just affordability measures, certainly when it comes to free contraception. I spent some time with the Irish Family Planning Association team on Cathal Brugha Street some time ago. That organisation was set up decades ago to respond to the negative impact on women's health at the time when contraception was banned. It was wonderful to be up with that group to say not only is it legal, but we are making it free for the first time in the history of the State. While it is an important affordability measure, it is also an important statement of intent that this Government, and Oireachtas, including this Seanad, are absolutely serious about and committed to a revolution in women's healthcare. This is one important part of that work.