Colm Brophy (Dublin South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

537. To ask the Minister for Health the estimated cost of providing five postnatal hubs. [45930/24]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The 2022 Women's Health Action Plan and the National Maternity Strategy 2016-2026 call for a coordinated approach to support postnatal women and new babies in the community. The National Maternity Experience Survey has shown that improving postnatal care is a priority for women. Since 2022, significant investment has been directed into piloting and establishing a national network of Postnatal Hubs. Five Hubs are already operational, with four more currently in development. Budget 2025 will provide four more Hubs, bringing the national network to 13.

These Hubs provide essential care for women in the community and closer to home in the weeks after birth. Women who have attended this service have reported how much they value the additional support, including hotlines, birth reflections, and physiotherapy.

To initiate the first two Postnatal Hubs, in 2022 €0.9 million was allocated through the Women's Health Fund. In the same year, this Government provided unprecedented funding of €8.7 million for the National Maternity Strategy, through which three further Postnatal Hubs were funded. A total of five Postnatal Hubs were open by the end of 2023 in Cork, Kerry, Portiuncula, Sligo and Carlow-Kilkenny. €0.4 million was allocated in 2024 to establish four more Postnatal Hubs, with a full year cost of €1.9 million in 2025. This Government is investing an additional €2.0 million in the National Maternity Strategy in Budget 2025, which includes €0.9 million to open four further Postnatal Hubs.

On this basis, the estimated Full Year Cost to establish five additional Postnatal Hubs would be €2.3 million.

These costs may be subject to inflationary increase. A review is ongoing into the first pilot Postnatal Hubs, which may also have implications for the projected costs in the future.

Colm Brophy (Dublin South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

538. To ask the Minister for Health the estimated cost of providing five menopause clinics and increase the hours of all such clinics by one additional hour. [45931/24]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

There is currently one specialist menopause clinic in each of the six maternity networks.

The existing specialist menopause clinics have been operating with 1.7 Whole-Time Equivalents (WTEs) each. These comprise a team of 3-4 staff, made up of Consultants/Specialist GPs, Clinical Nurse Specialist /Clinical Midwife Specialist, and Grade IV Admin.

The total full-year salary costs (including 20% non-pay) that have been funded for the existing clinics, are as follows:

• Coombe: €173,611
• Rotunda: €165,607
• NMH: €175,541
• Cork: €166,409
• Galway: €166,409
• Limerick: €166,409

As part of the Women’s Health Action Plan, additional funding for the existing menopause clinics is being provided this year to extend their opening hours. This funding will provide an additional 2.8 WTEs spread across the NMH, Rotunda, Cork and Galway.

The full-year cost for the additional 2.8 WTEs is €349,415. Taking this into account, the average cost per clinic will increase to €227,217. Capital investment may also be required for any additional clinics, and this would vary depending on the space available and refurb/equipment requirements.

The HSE’s National Women & Infants Health Programme has advised that clinics typically operate on a 3- or 4-hour basis, with staff on 35-37 hour per week contracts.

Colm Brophy (Dublin South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source

539. To ask the Minister for Health the estimated cost of increasing funding to the HIV PrEP programme by 10%. [45932/24]

Colm Burke (Cork North Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

A national HIV pre-exposure prophylaxis (PrEP) programme commenced in November 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving.

Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services. These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.

The number of people eligible to access PrEP has been expanding since inception, with the number of individuals re-imbursed for PrEP at least once expanding from 1763 in 2020 (the first full year of service delivery), to 3388 in 2022 and 3802 by the end of Q4, 2023.

Clinical criteria for PrEP eligibility have been widened in recent years, increasing the number of people eligible for the programme. While the PrEP service continued to grow in 2023, many PrEP services are reaching (or have reached) capacity and service users are reporting challenges accessing appointments. By the start of Q4, 2024, 6,070 individuals were approved for free PrEP medication. Additional work is required to understand the extent of the unmet need/demand for PrEP, which has been estimated as circa 30%.

In order to expand these services and provide additional supports to our rapidly growing population, we have been allocated additional funding of €600,000, through Budget 2025, to further support delivery of the PrEP scheme, bringing the total allocation to €5.9m. This additional funding is comprised of €0.2m for additional PrEP drug costs, and €0.4m for additional staffing in the public STI clinics from July 2025, increasing capacity for in-person appointments. The additional allocation comprises approximately 11.5% of the 2024 PrEP budget.

Furthermore, the home STI testing scheme is being used to support the PrEP programme; an additional €0.6m has been allocated to support this, given increasing demand for the service. This brings funding for home STI testing to €4.82m in 2025.

In order to increase capacity, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP.

It is of vital importance that people at risk of HIV and living with HIV (PLHIV) are promptly linked to care, for prevention of onward transmission and for clinical benefit. It is also vital that those at risk are encouraged to access regular testing and preventive programmes such as PrEP. These measures are key elements towards achieving UN and WHO aims of ending the HIV/AIDS epidemic in Europe by 2030 and supporting wider national and international commitments.

In addition to further funding for both PrEP and for home STI testing in 2024, we are progressing further development of HIV Fast-Track Cities in Dublin, Cork, Limerick and Galway. We are also supporting people living with HIV and countering the stigma they may experience.

Additional capacity for PrEP delivery, through the public system, its partnerships and through primary care, are being considered as part of the wider ongoing work to redraft the National Sexual Health Strategy, which is almost complete. Measures included for consideration will include a Model of Care for sexual health, to examine capacity and delivery, nationwide, in the context of HIV and STI rates that are rising both nationally and internationally.

As PrEP capacity is a service matter, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.