Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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524. To ask the Minister for Health the details of the IVF scheme in maternity hospitals; the criteria for same; the way in which eligibility for the scheme is determined; the waiting list for same; the hospitals in which it is available; the way in which a referral can be obtained; and if he will make a statement on the matter. [8339/20]

Simon 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 care (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 involves the development of Regional Fertility Hubs at secondary care level.  Funding of €2m has been provided to develop these 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.

Substantial progress has been made in respect of the development of these Hubs, despite the work having to be slowed due to the management of the Covid-19 pandemic by the health service broadly and its impact upon the provision of elective health services, including fertility services.  The normal work programmes in the HSE and the Department of Health have resumed for the most part, allowing the continuation of Phase One of the roll-out of the model of care, and specifically the development of the first four of the Regional Fertility Hubs.

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.