Fiona O'Loughlin (Fianna Fail) | Oireachtas source

I really am delighted to be standing here today with my brave, open and courageous colleague, Senator Catherine Ardagh, who just laid bare her life over the last number of years. I really appreciate it. I have learned a lot from Catherine since we started on this journey with regard to drafting this Bill. I came to this Bill not from personal experience but from listening to and understanding the experience of family and friends and by reading about others. We have put countless hours and huge work into this Bill over the last number of years. Together with Senator Ardagh, I want to add my voice of thanks to Ms Kate Butler and the Office of Parliamentary Legal Advisers, OPLA, for their patience and support in getting us here today. I also thank Professor Mary Winfield for her invaluable advice along the way.

Fertility issues in Ireland are much more common than many of us realise. As many as one in six couples in this country will experience fertility issues, which affect men and women equally. In many ways, this is an equality issue. It is about equity of access to the supports that are needed by some to start their own families. Money should not dictate whether people have access to fertility treatment or not. At the moment, however, it does. We all know people who have remortgaged homes or, indeed, put off buying their own homes because of the need to pay costs related to IVF. I know the Minister agrees that Ireland needs to have a service that is safe, effective and, most importantly, accessible. As it stands, that is not the case and the State does not do enough to support couples who, of course, are not facing just financial challenges but that huge impact on their lives of worry, waiting and maybe failing, and the pain of all of that.

This, of course, is not just an Irish issue. Infertility is a worldwide health issue with infertility rates increasing in recent years in all communities in both the developing world and developed world. It is not only a medical condition but it is a social condition.

At present, Ireland is in the very shameful position of being ranked 40 out of 43 countries when our fertility policy is benchmarked internationally. That is simply not good enough. That was the very reason Senator Ardagh and I started on this journey. Assisted human reproduction is one of the fastest-growing healthcare industries in recent years with IVF experiencing the most significant increase in demand. On average, there are 6,000 cycles of IVF treatment completed in Ireland each year. At the moment Infertility treatment, such as IVF, takes place in private and not-for-profit clinics in Ireland. Assisted human reproduction is not regulated in Ireland, although it has been practised since 1987. We are looking forward to seeing that brought forward in regulation very soon, however. I thank the Minister for his work on that.

The number of treatment cycles per annum in Ireland grew in the period 2009 to 2020 from 7,859 to a peak of 11,359. While all those who experience fertility issues in Ireland might not need IVF or intracytoplasmic sperm injection, ICSI, many of them will require some form of assisted human reproduction treatment. Those in need of fertility programmes find themselves paying between €6,000 and €10,000 per cycle. As I mentioned, that situation compares very unfavourably with most of our European counterparts.The cost of IVF realistically, with blood tests and consultations, comes out at nearly €10,000. At the moment, only fertility drugs are covered by the drugs payment scheme or a medical card. Private patients can claim tax relief on fertility drugs, but that is it. There is nothing else to support those in this situation.

Approximately 9,000 couples are availing of IVF here at the moment, but it is estimated that 3,000 women travel abroad every year for fertility treatment in Europe. People who are desperate to have a child are most vulnerable and hugely open to exploitation. They sometimes pay ransom amounts of money to fulfil their wish and desire to be parents.

Senator Ardagh and I have campaigned tirelessly for a properly funded public health IVF scheme. We were delighted when the Minister in budget 2023 confirmed additional finance and supports for publicly funded IVF treatment. That was a hugely important step. We look forward to seeing it being realised. It is another example of Fianna Fáil’s ambition to transform healthcare in this country. This Bill is a further building block for the proper provision of fertility treatment in Ireland and seeks to complement the Minister’s AHR legislation of 2022. Since we publicised that we were introducing this Bill, some people get in contact with me and Senator Ardagh to say they were concerned this Bill might impact on the previous Bill. I assure anybody listening this will not delay or impact the current AHR Bill and certainly will not affect the roll-out of public funding for IVF treatment in September 2023.

Our Bill proposes that the committee will advise and make recommendations to the Minister for Health on the criteria for eligibility for financial assistance with fertility treatment, in addition to the age of persons that can obtain treatment, the welfare of any child that may be born as a result of such treatment and any other criteria determined by the Minister. This places the responsibility of whether there will be public funding in the form of full or partial coverage and the attached conditions - such as medical indication, single-embryo transfer, number of cycles and up to what age - in the hands of experts in this field. We do not claim to be experts. We are coming at this from a humane and compassionate point of view and have the luxury of being able to introduce this as legislators.

In a survey by Sims IVF that was conducted last month among 1,088 respondents, 54% said they would consider delaying further treatment until public funding is rolled out. The remaining 46% said they would not delay further treatment, even if funding came through this year. We have nearly half of those couples putting their plans on hold in the hope of receiving State assistance. We are clear we want this to happen as soon as possible, but we have to send a message to those thinking of putting plans on hold: please do not do that. We all know or at least know of someone who has gone through the process and from them we know the mental toll and emotional distress the process can have. We need to make progress on this. Some 18% were angry over the length of time it is taking to get public funding and concerned about the exacerbation of waiting lists for treatment, while 12% of people lacked confidence in implementation of public funding, querying whether the roll-out will be means-tested and if patients with medical cards will be prioritised. I hope this Bill and the Minister’s clear commitment to delivering the roll-out on a universal basis will help alleviate any anxieties that may exist in the general public.

The World Health Organization is clear that infertility is a disease and should be treated as such. We provide excellent services for a host of other diseases in our public health service and fertility should be no different. I thank the Minister for his work to date on this issue and for his collaboration, especially on the women’s health agenda.