Paul Murphy (Dublin South West, RISE)
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477. To ask the Minister for Health his plans to provide public funding for IVF in 2023 (details supplied); the amount of funding that is being provided; the persons that will be eligible to access this treatment; and if treatment will be available within the public system rather than being outsourced to private operators. [21930/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The model of care for infertility was developed by my officials in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary.

This model of care comprises three stages, starting in primary care (i.e., GPs), 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), with patients being referred onwards through structured pathways.

Phase One of the roll-out of the model of care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. The completion of Phase One of the roll-out of the model of care, envisaged before the end of this year, will result in fully operational Regional Fertility Hubs in each of six Hospital Groups across the country.

Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system, but will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated and the AHR legislation commenced, which will allow for a robust regulatory framework to be put in place.

In respect of the last point, the Health (Assisted Human Reproduction) Bill 2022 passed Second Stage in the Dáil on March 23rd 2022 and has been referred to the Select Committee on Health for Third Stage. I am fully committed to progressing this important legislation as quickly as possible.  

My officials will be continuing and intensifying engagement with NWIHP over the coming weeks in respect of the issues arising from commencing Phase Two of the roll-out of the model of care and as such, no firm decisions have been made at this juncture in relation to, for instance, the ensuing budgetary requirements, relevant access and eligibility criteria which may be applied, or how exactly advanced AHR treatments will be provided. 

While advanced AHR treatment, such as IVF, 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 understand 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 IVF, or other advanced AHR treatment, privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.

Nevertheless, my Department and the Government is fully committed, through the full implementation of the model of care for infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.