Paul Kehoe (Wexford, Fine Gael)
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1697.To ask the Minister for Health the reasons the HSE is no longer funding the provision of Dexcom sensors for use by diabetics on insulin injections; if there are plans to reverse this decision; and if he will make a statement on the matter.[34349/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Paul Murphy (Dublin South West, RISE)
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1698.To ask the Minister for Health his views on whether the discrimination against people who are HIV+, which means they are denied access to IVF, should be ended.[34350/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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As per European legislation – and as transposed into Irish law as the European Communities (Quality and Safety of Human Tissues and Cells) Regulations 2006 – patients undergoing advanced fertility treatment such as IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection) are required to undergo viral screening. This mandatory requirement screen bloods for the presence of HIV 1 & 2, Hepatitis B core antibody and surface antigen, Hepatitis C and syphilis. Section 2.3 of Schedule 3 of the 2006 Regulations states: “Where HIV 1 and 2, hepatitis B or hepatitis C test results are positive or unavailable, or where the donor is known to be a source of infection risk, a system of separate storage must be devised”. The Health Products Regulatory Authority (HPRA) holds responsibility for ensuring compliance with the 2006 Regulations; however, neither I, as Minister for Health, nor the HPRA has the power to direct private assisted human reproduction (AHR) providers operating in this country to put in place the necessary facilities and systems to cater for prospective patients who have, for example, tested positive for HIV.

As part of the final phase of the roll-out of the Model of Care for Fertility, referrals for AHR treatment by one of eight HSE-approved private providers, as chosen by the eligible patient concerned, commenced in September 2023. As well as IVF and ICSI, the funding allocated is also being used to provide, again initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive treatment.

In relation to the management and care of public patients who are HIV+, within the pool of the eight private AHR providers, the HSE has informed my officials that three are currently positioned to manage women with HIV who require IUI and whose partner is negative. If alternative advanced treatment such as IVF or ICSI is required, in which the gametes (egg or sperm) of the patients are handled and managed as part of the care, no AHR provider in Ireland is currently positioned to offer care if either the female or male is HIV+.

Funding has been made available to develop the first public National AHR Centre which is scheduled to open in Cork next year. The HSE’s National Women and Infants Health Programme (NWIHP) is currently working with the Cork AHR team with a view to developing in the first instance an IUI service that can manage patients living with HIV. This service is being developed in close collaboration with the infectious disease services and will involve the development of a joint package of care, such that a couple requiring IUI treatment can receive it in time in the Cork Centre and will no longer have to travel abroad. With the planned development and delivery of further advanced treatments in Cork, such as IVF, again NWIHP is working with the Cork team to assess the ability and feasibility of providing those services to patients living with HIV – thereby removing the need for any couples to travel abroad for treatment.

Any couple identified at Regional Fertility Hub level, in which one or both partners are living with HIV, clinically require AHR treatment, meet the national access criteria, and cannot be managed and cared for within the current network of HSE-approved providers will be able to receive their treatment under the HSE’s Treatment Abroad Scheme (TAS). The relevant Regional Fertility Hub, NWIHP and the TAS will work closely together in relation to meeting the needs of individual couples in this regard.

Whilst this work is ongoing, with a view to ultimately positioning the public service to meet the needs of individuals living with HIV in relation to the provision of advanced fertility treatment, it is important to note that no patient is being denied treatment. AHR treatment can be provided (subject to any eligibility criteria that might apply) by the HSE through the Treatment Abroad Scheme.

My Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system.