Dáil Éireann Debate, Wednesday - 26 November 2025
341. Deputy Pádraig Rice asked the Minister for Health further to Parliamentary Questions Nos. 1707, 1708, 1709 and 1710 of 4 November 2025, if healthcare providers must indicate on prescriptions that they are for the management of the symptoms of menopause such that pharmacists may submit claims for those prescriptions under the free HRT scheme; and if she will make a statement on the matter. [66624/25]
Amharc ar fhreagraUnder the Hormone Replacement Therapy (HRT) measure, which came into effect on 1 June 2025, where a woman has been prescribed HRT by her healthcare provider for the purpose of alleviating the symptoms associated with all stages of menopause, the cost of the HRT medications or products, and the pharmacy dispensing fees will be met by the State.
This measure is intended to support the management of the symptoms of menopause and, therefore, relates to the provision of treatment for the symptoms a specific medical condition/life stage i.e. menopause. HRT is the most commonly used treatment for managing symptoms of menopause and has shown to be the most effective intervention.
I am aware that HRT is used in the treatment of other medical conditions/circumstances, including gender-affirming healthcare, hypogonadism, IVF, and some cancer treatments. However, the current provision of the Free HRT Arrangement, legislated for under the Health Insurance (Amendment) and Health (Provision of Menopause Products) Act 2024, limits eligibility to those whose healthcare provider has prescribed HRT to alleviate the symptoms of menopause. The legislation does not make amendments to what must be included in a prescription for it to be considered valid.
Currently, prescriptions written by Irish registered prescribers practising in Ireland are valid whether presented in paper format or received through Healthmail. Healthmail is a secure clinical email service that allows health care providers to send and receive clinical patient information in a secure manner. The service is provided by the Primary Care Directorate of the HSE and is managed by eHealth Ireland and supported by the Irish College of General Practitioners and the Irish Pharmacy Union.
I am not in a position to comment on or intervene in individual cases, patient’s prescriptions, or decisions made by individual pharmacists in the exercise of their professional judgement.
Pharmacists have a legal and ethical responsibility to ensure that each dispensing is safe, appropriate, and in the best interests of the patient. These responsibilities are reflected in the Code of Conduct: Professional Principles, Standards and Ethics for Pharmacists (www.psi.ie/sites/default/files/2024-06/PSI's%20Code%20of%20Conduct%202019.pdf) which sets out the principles of professional practice expected of all pharmacists in Ireland. In particular, Principle 2 of the Code outlines the obligation to “provide safe and effective care,” and Principle 5 emphasises the need to “exercise professional judgment in the best interests of patients.”
These principles require pharmacists to consider, at each dispensing, not only the legal validity of the prescription, but also whether the continued supply of the medicine is clinically appropriate. This includes situations where the full 12-month supply may not be dispensed if, in the pharmacist’s judgement, further assessment is needed, or where clarity from the prescriber may be required.
Where a member of the public believes that a pharmacist has not acted appropriately or has not complied with their legal or professional obligations, they are entitled to make a complaint to the PSI. All complaints received are considered in accordance with the provisions of the Pharmacy Act 2007. A decision not to progress a complaint does not suggest that the concerns were not considered seriously, but rather that the statutory threshold for further action under section 36(1) of the Act was not met.
Alternatively, outside of the statutory complaints process, anyone can raise a concern with the PSI about the behaviour, conduct or practice of a pharmacist, or the service they have received in a pharmacy. All concerns are formally reviewed by the PSI to consider whether further action is needed. In these situations, those raising the concern are not kept informed of the outcomes of the internal reviews/actions taken by PSI. Further information is available on the PSI’s website: www.psi.ie/complaints-and-concerns/differences-between-complaint-and-concern.
As the HRT arrangement is administered by the Health Service Executive, I have also them to respond to the Deputy directly, as soon as possible
