Joe O'Brien (Dublin Fingal, Green Party) | Oireachtas source

I thank Senator Fitzpatrick for this opportunity to speak to the House on the important topic of HRT provision for women in menopause. The Department of Health and the Minister, Deputy Donnelly, are committed to improving women's health. Since the establishment of the women's health task force in 2019, they have listened to what women want from the health service and have taken a number of positive steps to improve women's experiences and health outcomes. This includes the free contraception scheme, which is available to women aged between 17 and 30. There was an allocation of €31.5 million for the scheme this year, which covers the cost of consultations and, where appropriate, fittings, checks and removals of contraceptive devices. This is provided by GPs and family planning, student health and primary care centres. It also covers the cost of prescriptions for the wide range of contraceptive options available through the HSE reimbursement list. Budget 2024 provided €1.3 million in new development funding to expand the scheme to include to those aged 31 from next year.

HRT is a very different treatment and cannot be included in the contraception scheme. At present, there are no plans to expand the scheme to include HRT. Furthermore, the scheme is not open to women over the age of 40 who may be deemed clinically suitable for HRT. Any decision by the Government to provide free HRT to some cohorts of women would require separate, albeit analogous, primary legislation to give effect to such a decision.

To assist those women who choose to take HRT, the HSE operates two schemes that offer financial assistance to people in receipt of prescribed HRT medications which are on the reimbursement list. These HRT medications are available to medical card holders subject to the statutory prescription charge. Eligibility for the medical card under the GMS scheme is determined by the HSE in accordance with the Health Act. In certain circumstances, however, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines where he or she faces difficult financial circumstances, such as extra costs arising from illness. Under the drug payment scheme, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines, which include some HRT medication. In budget 2023, VAT was removed from HRT to assist women further with the associated costs.

Menopause can present differently for individual women in the context of symptoms, severity and duration. Not all women experiencing menopause may be clinically eligible for HRT that is prescription based. Women may also choose not to take HRT but to address their symptoms through alternative therapies and-or lifestyle changes. It is important that women and healthcare providers are educated on the use of HRT and other options and that together they explore all of the available options open to them.

I thank Senator Fitzpatrick for raising this issue and providing me with the opportunity to speak today on the important aspect of women's health.