Neale Richmond (Dublin Rathdown, Fine Gael)
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312. To ask the Minister for Health the steps being taken towards allowing those with epilepsy to access the medical cannabis access programme; and if he will make a statement on the matter. [51786/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Medical Cannabis Access Programme (MCAP) will make it possible for a medical consultant registered with the Irish Medical Council to prescribe a listed cannabis-based treatment for a patient under his or her care for the three conditions covered by the programme, where the patient has failed to respond to standard treatments:

The three specified therapeutic indications covered by the programme:

- Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions.

- Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes.

- Severe, refractory epilepsy that has failed to respond to standard anticonvulsant medications.

The (MCAP) is a 5-year pilot programme. The purpose of the programme is to facilitate access to acceptable cannabis-based products for medical use that are of a standardised quality and which meet the requirements outlined in the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 (as amended).

There are currently 4 products assessed by the HPRA for inclusion in Schedule 1 of the Regulations, more products are currently being assessed by the HPRA.

On the 19th July, I announced that the MCAP was now open for medical consultants to make an application for themselves and their patients to be registered for the programme. 

Registration by consultants and their patients on the Cannabis for Medical use Register, to be operated by the HSE, is required for the prescribing of cannabis-based products under the MCAP.

Róisín Shortall (Dublin North West, Social Democrats)
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313. To ask the Minister for Health his plans to expand the rollout of free contraception to those persons over the age of 25; the timeline for such a rollout; and if he will make a statement on the matter. [51788/21]

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The Programme for Government commits to providing free contraception for women, starting with the 17-25 age cohort.

Accordingly, funding for free contraception, starting with women aged 17-25, has been allocated in 2022. The initiative is gradually being introduced by age cohort, starting with younger women who are least likely to be financially independent and where cost has been shown to be a greater barrier to access contraception.

The scheme will provide for:

- The cost of prescription contraception;

- The cost of fitting and/or removal of various types of long-acting reversible contraception and administration of contraceptive injections plus any necessary checks, by medical professionals certified to fit/remove same;

- The cost of training and certifying additional medical professionals to fit and remove long-acting reversible contraception;

- The cost of a maximum of two consultations per annum with GPs and other doctors to discuss forms of contraception suitable for individual patients and to enable prescription of same.

- Training and certification of additional GPs to fit long-acting reversible contraception

It is envisaged that a wide range of contraceptive options, currently available to medical card holders, will be made available through this scheme. This includes contraceptive injections, implants, various types of intrauterine system (IUS) or device (IUD; commonly known as the coil), the contraceptive patch and ring, and various forms of oral contraceptive pill.

Funding for free contraception in Budget 2022 also includes an allocation for training of additional GPs in fitting and removal of various forms of long-acting reversible contraception (e.g. various forms of the coil and contraceptive implant). It is envisaged that this will commence in 2022.

In order to give time to bring forward the necessary legislative proposals and ensure the implementation of service delivery arrangements through the appropriate areas of the healthcare system, it is envisaged that the scheme will commence in August 2022, but this is dependent on legislative timelines.

In the meantime, it should be noted that those with a medical card already have access to most forms of contraception at minimal cost (subject only to the prescription charge), while those with a GP visit card are also supported to some extent as the clinical cost element of contraception is reduced. Furthermore, the Drugs Payment Scheme, for which anyone ordinarily resident in Ireland is eligible, covers the cost of prescription items, if these exceed the monthly limit, which will be reduced from €114 to €100 through measures included in Budget 2022. 

Some access to free contraception is already enabled in some contexts. the National Condom Distribution Service (NCDS), which was established by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) in October 2015, functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working with individuals and groups at increased risk of negative sexual health outcomes. The NCDS currently distributes free condoms through 25 HSE locations, 27 higher education institutions and 44 non-government agencies. 

It should be noted that, while oral contraception and various forms of long-acting reversible contraception can be more effective at preventing pregnancy, condoms provide protection against STIs that is not provided by non-barrier forms of contraception. 

It is envisaged that continued expansion of the NCDS will be facilitated in line with demand, in order to support the STI prevention and sexual health promotion needs of people living in Ireland