Alan Farrell (Dublin Fingal, Fine Gael)
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183. To ask the Minister for Health the progress that has been made in his Department since the formation of Government to promote women's health; and if he will make a statement on the matter. [26537/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Progressing women’s health is a priority for myself and for this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government 2020 and are fully committed to the continued development and improvement of women’s health services and to working with women and girls to improve their health and experiences of healthcare across the whole life cycle.

Underscoring our commitment to women’s health was the establishment of a Women’s Health Taskforce in September 2019 to improve both health outcomes and experiences of healthcare for women and girls. The Women’s Health Taskforce continues to work with the National Women’s Council of Ireland and the European Institute of Women’s Health to prioritise different issues each year with the aim of improving women’s health outcomes and experiences. Critical to this work is the process of listening to women - the Taskforce has so far listened to, engaged with and worked with thousands of women and hundreds of organisations representing women and girls across the country and commits to continued listening.

The Women’s Health Action Plan 2022-23 was published on 8 March 2022, marking International Women’s Day. The Action Plan identifies key actions to improve health outcomes and experiences for women in Ireland. It provides the foundation to address women’s whole health and help ensure that action on women’s health looks beyond reproductive health to make a real difference to women’s lives.

Prioritisation of women’s health is further supported through the significant investment contained within Budget 2022 and 2023,which allocated €31m and €69.2m respectively in funding for new developments in Women's Health. This includes:

2022:

• €8.66 million additional funding for the National Maternity Strategy.
• €9 million to fund access to free contraception for women aged 17-25.
• €5.3 million to grow access to “see and treat” gynaecology clinics; specialist menopause clinics; and specialist endometriosis services.
• €1.34 million to support initial establishment of a perinatal genetics service.
• €0.71m investment in tackling period poverty for the first time.
• €0.54million to establish an expert Obstetric Event Support Team to support services and sites that report severe maternity incidents
• €0.25m additional investment in Sexual Assault Treatment Units.
• €10m Women’s Health Fund, supporting implementation of key priorities for women's health.

• €11.7 million to provide access to publicly funded IVF treatment.
• Elimination of VAT on HRT and period products.
• Expansion of the Free Contraception Scheme to cover women aged 30 and under.
• €10million investment in the Women’s Health Fund to continue support for women’s health priority areas.
• €0.9m investment in the development of Women’s Health Hubs, for the holistic provision of women’s healthcare.

• Contraception: A scheme to provide free contraception to women aged 17-25 was launched successfully on 14 September 2022 and was expanded to include 26-year-olds on 1 January 2023. Budget 2023 has allocated funding to support the scheme and work is underway expand it to women under 30 in 2023.
• Menopause:6 Specialist Menopause Clinics to treat complex symptoms of Menopause, with 5/6 clinics currently open and operational. A GP Quick Reference Guide on Menopause was launched in October 2022 to support primary care practitioners in treating menopause and referring patients to Specialist Clinics. The first National Menopause Awareness Campaign (Radio, Online, Print, TV) was launched by the Department of Health to raise awareness and “lift the taboo” around menopause. www.gov.ie/en/menopausewas launched as a one-stop shop for information about menopause and its symptoms as well as advice on proactive management. Removal of VAT from HRT in Budget 2023.
• Fertility:6 Regional Fertility Hubs are being established to provided tailored, low-level intervention for patients with fertility issues. Investment to support publicly-fund Assisted Human Reproduction has also been allocated and will see the first National Advanced AHR Centre established.
• Gynaecology:A network of 20 “see and treat” ambulatory gynaecology clinics are in development, where an estimated 70% of general gynaecology referrals are suitable for management. 13 Ambulatory Gynae Clinics are currently open and operational, with additional clinics in development. The national network will improve access to services; help to reduce the requirement for multiple gynaecology appointments; help to ensure sustainability of service provision into the future given the significant waiting lists for this specialty; and will, ultimately, help improve clinical outcomes.
• Maternity: Under Budgets 2021 and 2022, €16m in new development funding was allocated to the National Maternity Strategy to ensure the continued implementation of the Strategy and the ongoing roll out of the Strategy’s model of care. This investment is providing for further development of community midwifery services, expansion of breastfeeding supports, improved access to allied and specialised services and strengthened training and education supports for staff. This investment is also improving the infrastructure of our maternity services by providing additional home-from-home birthing suites and upgrades to theatres and wards.
• Mental Health:The Women’s Health Fund provided investment in 2022 to support a range of services for women and girls, including digital mental health services access, improving perinatal mental health supports, enhancing specialist eating disorder supports, providing targeted mental health supports for marginalised women and women in addiction and responding to the needs of young girls at risk of developing psychosis.
• The Women’s Health Fund has invested in a range of service areas, responding to the needs of women in year. Areas include cancer screening and immunisation, primary care supports, maternity services and postnatal hubs, gynaecology, mental health and supports for marginalised groups.
• Period Poverty:Removal of VAT from period products in Budget 2023. Funding of €714,000 was allocated for period poverty initiatives in Budget 2022, this funding was then increased in 2023 to €814,000. This funding supports period dignity measures rolled out in partnership with the HSE, local authorities and NGOs. To date in 2023, period poverty supports have been allocated to 18 Local Authorities and 10 NGOs. The Healthy Ireland Survey, 2022, included a module on menstrual health and period poverty, finding that 51% of women currently having periods experience disruption to participating in daily life (work, school, sports, social events) as a result of symptoms, and that 24% have experience of period poverty.

Alan Farrell (Dublin Fingal, Fine Gael)
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184. To ask the Minister for Health the progress that has been made in his Department since the formation of Government in implementing publicly-funded fertility treatment services; and if he will make a statement on the matter. [26538/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy will 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 Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related 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) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) 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 fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking.

There are currently five out of six Regional Fertility Hubs in service and the completion of Phase One of the roll-out of the Model of Care, envisaged for later this year, will result in fully operational Regional Fertility Hubs at six locations across the country.

Phase Two of the roll-out of the Model of Care will see the introduction of tertiary fertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care.

This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the historic development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic and is scheduled to open in 2024. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.

The 2023 allocation is also being utilised to support the Regional Fertility Hubs in order to expand the scope of services by introducing the provision of IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive, type of AHR treatment.

Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023.

My Department and the Government is fully committed, through the full implementation of the Model of Care for Fertility, to ensuring that patients always receive care at the appropriate level of clinical intervention.