Written answers

Thursday, 5 March 2020

Department of Health

Assisted Human Reproduction Services Provision

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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599. To ask the Minister for Health if a report will be provided regarding the way in which private sector IVF is regulated; his further plans in place in this area; and if he will make a statement on the matter. [2870/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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As the Deputy will be aware, currently there is no specific legislation in Ireland governing assisted human reproduction (AHR), although there is limited existing regulation relating to certain aspects of this area – for instance, regarding the use of gametes and embryos – as outlined in the response to a previous similar question submitted by the Deputy (PQ 194 of 17 October 2019; ref. 42703/19).

Given the lack of specific regulation in this area, the Government approved the drafting of a bill on AHR and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. This comprehensive piece of legislation encompasses the regulation of a range of practices, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research. The General Scheme also provides for an independent regulatory authority for AHR. The provisions outlined within the General Scheme will ensure that AHR practices and related areas of research are conducted in a more consistent and standardised way and with the necessary oversight.  

In respect of the query as to whether a report will be provided on this issue, I wish to state that the focus of officials in my Department at this juncture is on ensuring that the legislation is published as soon as possible and thereafter assisting its progress through the Houses of the Oireachtas.

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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600. To ask the Minister for Health the details of the IVF scheme in maternity hospitals; the criteria for same; the way in which eligibility is determined for such a scheme; the waiting list for same; the hospitals from which it is being operated; the way in which a referral is made or can be obtained; and if he will make a statement on the matter. [2871/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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As the Deputy will be aware, I announced the roll-out of a model of care for infertility in December last year.  This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary.  It will comprise three stages, starting in primary care (i.e., GPs) and extending into secondary (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF and other advanced assisted human reproduction (AHR) treatments).  Structured referral pathways will be put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate.  It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years.

Phase One of the roll-out of the model of care will see the development of infertility services at secondary care level.  Funding of €2m has been provided to develop Regional Fertility Hubs in maternity networks which will facilitate the management of a significant proportion of patients presenting with infertility issues.

Phase Two will see the introduction of tertiary infertility services, including IVF, in the public health system.  This cannot commence before the service is regulated through the Assisted Human Reproduction Bill.  The drafting of this comprehensive piece of legislation is ongoing in conjunction with the Office of the Attorney General.

It should be noted that while AHR treatment is not currently funded by the Irish Public Health Service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE.  Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme.  Given the costs associated with certain fertility medicines, I am aware that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.

In addition, there is other support available in that patients who access AHR treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. 

Overall, the implementation of the model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.

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