Dáil Éireann Debate, Tuesday - 1 July 2025
785. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of introducing a fully funded universal contraception scheme; and if she will make a statement on the matter. [35677/25]
View answerThe free contraception scheme was launched in September 2022, initially for those aged 17-25. It has been gradually expanded and has included women aged 17-35 since July 1st, 2024.
Approximately 2,400 GPs and 2,050 pharmacies have signed up to provide services and products under the scheme to date. The scheme is open to women, girls and people identifying as transgender or non-binary, who are ordinarily resident in Ireland and for whom prescription contraception is deemed suitable by their doctors.
The scheme 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 Re-Imbursement List, including long-acting reversible contraception (LARCs: injections, intra-uterine 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 remain eligible for subsequent checks and free removal of any devices inserted prior to reaching the eligibility limit (currently their 36th birthday), to ensure continuity of care.
Initially, prior to launching the scheme, it was estimated that each year age cohort would cost €2.9m per year approximately, in line with the estimated cost range published in the Report of the Working Group on Access to Contraception. Usage figures following scheme expansion indicate that, while this figure is broadly accurate for younger women, costs decline significantly with age.
Based on real world costs, therefore, it is estimated that expanding the scheme further would cost approximately €1m per year age-cohort, per annum, above the age of 35. The total cost of full expansion to include 36-54 year-olds, inclusive, is therefore estimated at €19m. The prescription of contraception is typically not clinically recommended from age 55 onwards.
A phased introduction of the free contraception scheme was undertaken for a number of reasons:
• A phased approach permits additional training in line with service expansion, allowing time for more medical and other relevant healthcare professionals to be trained to fit, check and remove long acting reversible contraceptives (LARCs). The demand for LARCs is predicted to rise with age, and the demand for short acting hormonal contraception to fall.
• The Report of the Working Group on Access to Contraception noted risks regarding the number of GPs qualified to undertake these procedures in 2019, versus likely demand once cost barriers were removed.
• A training scheme was funded and is underway, managed by the ICGP, which is steadily increasing the numbers of GPs with the expertise to fit, check and remove coils and implants.
• Budgetary and financial planning guidelines recommend that demand-led schemes, such as the free contraception scheme, should be subject to pilot testing and/or phased implementation, in order to monitor the effectiveness of the scheme and real-world costs.
• 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.
It is important to note that prescription contraception, while being 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. 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.
