Written answers

Tuesday, 12 July 2022

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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997. To ask the Minister for Health the timeline for the free contraception scheme, the roll-out of the initial phase for 17-to 25-year-olds and the extension of the scheme to those under 17 and over 25 years; and if he will make a statement on the matter. [37839/22]

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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The Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort. My Department's Contraception Implementation Group, convened in July, 2021, has been working with partners, including the HSE, towards ensuring that the scheme will commence in late August or early September 2022. Funding of approximately €9m has been allocated for this in Budget 2022.

- The cost of prescription contraception;

- The cost of necessary consultations with medical professionals to discuss suitable contraception for individual patients and to enable prescription of same;

- The cost of fitting and/or removal of various types of long-acting reversible contraception (LARCs) 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 LARCs;

- The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.

The legal framework for the scheme will be provided by the Health (Miscellaneous Provisions) (No. 2) Bill, 2022, which was passed by the Dáil on 6th July, 2022 and will be debated by Seanad Éireann on 12th July, 2022. Should the Bill pass all stages and be signed into law, it is envisaged that the scheme will be launched in late August or early September, 2022.

Formal consultations with medical representative bodies with regard to service provision under the scheme have commenced and are ongoing. The design of citizen engagement information and publicity campaigns to support and promote the roll out of the scheme will be finalised in the coming weeks by officials in the Department’s Press and Communications Team, the HSE’s Communications team and relevant subject matter experts.

In terms of considering the expansion of the scheme to wider age cohorts, it is recommended by the Public Expenditure Code that policy changes with significant Exchequer cost implications should be phased in and/or be subject to piloting and formal evaluation, before full roll out. This is particularly pertinent in the case of schemes, such as this one, which are demand-led. It is envisaged that, for quality control and other logistical reasons, including the monitoring of health service capacity in terms of LARC fitting and removal, a minimum of 12 to 18 months would be needed for monitoring of service delivery to 17-25 year-olds, prior to any further major expansion of the scheme.

In relation to extending the age cohort specifically to girls under the age of 17, It is important to note that the Health (Miscellaneous Provisions) (No. 2) Bill 2022 in the form passed by the Dáil, does not preclude the scheme being extended to girls under the age of 17. It provides that such an extension cannot be done under regulations to be made by the Minister for Health, meaning such an extension of the scheme would require a legislative amendment to be brought before the Oireachtas. I gave a commitment in Dáil Éireann (Committee Stage debate, 06/07/2022), that consideration of the needs of this girls under 17 would be considered by my Department as soon as this Health (Miscellaneous Provisions) (No. 2) Bill, 2022 has been commenced.

If the Bill passes all stages in the form it was passed by Dáil Eireann, my Department will commence the relevant consultations across Government, including engagement with the Oireachtas Health Committee. Subject to the outcome of these consultations, in particular resolving any potential obstacles, legal or otherwise, it is my intention, subject also to the required Government approval, to bring any necessary legislative amendments before the Houses of the Oireachtas, for full debate and scrutiny, at the earliest possible opportunity.

Finally, it is important also to clarify that the sole purpose of the contraception provisions contained in Part 3 of the Health (Miscellaneous Provisions) (No. 2) Bill 2022 (in the form as passed by the Dáil), is to transfer the costs of contraception from the patient to the State, starting with women aged 17-25.

Every day, GPs see women and girls of all ages, up and down the country, in their practices, to prescribe contraception, both for the purposes of birth control, and to ameliorate pain, heavy bleeding, mood disorders and other symptoms of the menstrual cycle for which medical help is often needed.

This Bill, if enacted, will have no impact on normal practice in this regard, for women over 25 and girls under 17. The normal operation of services provided by GPs, their clinical judgement and the medications and devices they may decide to prescribe are not a matter for this Bill, which is concerned only with removing the financial barriers to accessing contraception, starting with women aged 17-25.

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