Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1906. To ask the Minister for Health the rationale for restricting the free contraception scheme to women aged 17–35; if she will outline the evidence base used to determine these age limits; and if she will set out a timeline for the scheme’s extension to all women. [59163/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1907. To ask the Minister for Health whether a cost–benefit analysis has been undertaken to assess the financial and public health impact of extending the free contraception scheme to all women, including those aged 36 and above. [59164/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1908. To ask the Minister for Health if she has sought legal or equality advice regarding whether the current age restrictions on the free contraception scheme could constitute age discrimination under equality legislation. [59165/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1909. To ask the Minister for Health if her Department has undertaken an equality impact assessment under the public sector equality and human rights duty in relation to the free contraception scheme; if she will outline the outcome of that assessment; and if she will address concerns that the current age-based eligibility criteria may constitute indirect discrimination on the grounds of age or gender under the Equal Status Acts. [59166/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1910. To ask the Minister for Health if her Department has examined whether restricting access to free contraception to women aged 17–35 is compatible with the Equal Status Acts and the public sector equality and human rights duty. [59167/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 1906 to 1910, inclusive, together.

The Free Contraception Scheme (FCS) for women aged 17 -25, ordinarily resident in Ireland, was launched in September, 2022. Its remit has been expanded gradually to include women aged from 17 to 35 inclusive, with the most recent expansion taking place from July 1st, 2024.

Approximately €47m has been allocated to support the scheme in 2025 and approximately 2,350 GPs, primary care, family planning and student health centres and 1,950 community pharmacies across the country have participated to date in 2025.

The FCS covers the cost of consultations with GPs, primary care, student health and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Reimbursement List, including long-acting reversible contraception (LARC): injections, intrauterine devices and systems (coils) and implants) and emergency contraception in addition to the contraceptive Pill, patch and ring. LARC fittings, removals, injections and check-ups are also free of charge under the scheme.

Women who have had coils, IUDs, IUSs or implants inserted while eligible under the scheme will remain eligible for subsequent checks and free removal of any devices inserted prior to their 36th birthday, to ensure continuity of care.

Access to free contraception is also available on an emergency basis through the National Women and Infants Health Programme (NWIHP), enabling maternity units, hospitals, postnatal clinics and Sexual Assault Treatment Units (SATUs) to provide free contraception to patients who might be experiencing a range of issues in accessing the scheme through GPs and pharmacies. These include individuals attending postnatal or post-termination of pregnancy (ToP) appointments, those accessing SATUs in emergency situations, and those facing various barriers to accessing contraception through primary care, including but not limited to domestic, sexual and gender-based violence.

Similar supports for accessing contraception are in place with the Women’s Health Service, which supports women working in the sex trade. Staff training, through NWIHP, is being put in place to expand the numbers of trained staff in maternity, SATU and other specialist hospital settings (e.g. STI clinics), where patients would benefit from access to LARCs.

In the context of patients attending the SATUs or other HSE services who may be living with domestic, sexual and gender-based violence (DSGBV), the HSE National Social Inclusion Office (NSIO) has developed the HSE National DSGBV Training Programme. There are six HSE SATUs located around Ireland, which strive to provide a 24 hour, 7 days a week service to men and women over the age of 14 years who have experienced sexual violence. Eligible women and people identifying as transgender, non-binary or gender-fluid attending the SATUs who might benefit from contraception in emergency situations can now be offered it, free of charge.

There is no public health related reason to limit the scheme by age, up to the age of 55 (after which, prescription of contraception is not clinically recommended). The phased introduction of the scheme was recommended for a number of other reasons, as follows:

1. As per the recommendations of the Report of the Working Group on Access to Contraception (published in 2019 and available on the Department’s website), it was decided to commence the scheme with younger age cohorts, as they are most likely to experience unplanned pregnancy and least likely to be financially independent.

2. The Report of the Working Group on Access to Contraception also highlighted concerns around the capacity to fit LARCs; at the time, estimated at about 1,000 GPs. A phased approach permits additional GP training in line with service expansion, minimizing the risk of significant waiting lists arising. The ICGP have been funded under the scheme, since the launch in 2022, to provide additional LARC training.

3. Coils and implants can also be used to treat peri-menopausal symptoms such as irregular periods and heavy bleeding (menorrhagia); anecdotally, demand for these devices is higher in women aged from their late 30s to early 50s, making it imperative that numbers of GPs trained to fit LARCs are gradually increased in tandem with eligibility for the scheme.

4. Budgetary and financial planning guidelines included within the Public Spending Code recommend that demand-led schemes which are likely to incur significant Exchequer costs (such as the FCS) should be subject to pilot testing and/or phased implementation, as the potential risks of implementing full access to a demand led scheme without testing real world costs are considerable.

The Programme for Government, Securing Ireland’s Future, the National Sexual Health Strategy, 2025-2035, the Sláintecare 2025+ Plan and the Women’s Health Action Plans all commit to further sequential expansion of the scheme, such that it encompasses the full reproductive age-range in due course. However, any decisions relating to further expansion of the scheme must be considered through the Estimates process in advance of the annual Budget each year.

An analysis of likely costs and benefits of introducing free contraception, in terms of both financial and public health impacts, and referencing the findings of the Joint Oireachtas Committee on Repeal of the Eighth Amendment to the Constitution, was published within the Report of the Working Group on Access to Contraception (available here: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/).

Based on updated real-world scheme usage rates from July, 2024- August, 2025, it is likely that the costs of full extension would be significantly less than envisaged in the Report, with the current budget for the scheme being approximately 47m and additional costs estimated at a maximum of €1m per additional year cohort, bringing projected costs of extension to age 55 to approximately €67m.

In terms of engagement with the Irish Human Rights and Equality Commission (IHREC), we have submitted a Public Sector Equality and Human Rights Duty Assessment Document for the National Sexual Health Strategy (NSHS), 2025-35 and National Sexual Health Action Plan, 2025-28, following discussions with IHREC.

The NSHS 2025-35 includes the FCS within its remit and commits to its further expansion within the 10-year lifespan of the Strategy. However, as previously stated, the timelines for this are dependent on the Estimates process preceding the Budget each year. The Assessment Document was submitted to IHREC in September 2025, following publication of the Strategy in June, 2025.

It is important to note that prescription contraception provided through the FCS, while very effective at preventing unplanned pregnancy, does not protect against sexually transmitted infections (STIs). The National Condom Distribution Scheme supports both STI prevention and accessible contraception for men and their partners. Free condoms can be accessed through the national network of STI clinics, participating charities and NGO partners and on participating 3rd level campuses. Since 2023, free condoms have also been supplied with orders for free home STI testing kits.