Dáil Éireann Debate, Wednesday - 24 June 2026
257. Deputy Shónagh Ní Raghallaigh asked the Minister for Health for an update in relation to progress being made to resolve clinical and regulatory issues which stand in the way of single women and same-sex couples in accessing free AHR; and if she will make a statement on the matter. [47905/26]
Amharc ar fhreagra267. Deputy Shónagh Ní Raghallaigh asked the Minister for Health if she will review eligibility criteria for publicly funded fertility treatment to ensure the inclusion of same-sex couples and single women who require donor sperm; if she will confirm the current eligibility structure contravenes equality legislation; her plans to reform this discriminatory element of the scheme; and if she will make a statement on the matter. [47934/26]
Amharc ar fhreagra268. Deputy Shónagh Ní Raghallaigh asked the Minister for Health if her Department is aware of unequal access to public IVF funding, specifically disadvantaging single parents and same-sex families; whether her Department is taking steps to address this discriminatory aspect of the scheme; and if she will make a statement on the matter. [47935/26]
Amharc ar fhreagraI propose to take Questions Nos. 257, 267 and 268 together.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
The Model of Care comprises three stages of care. These begin in primary care (GPs), progress to secondary care through the six HSE-run Regional Fertility Hubs located across the country, and, where clinically indicated, advance to tertiary care.
Patients, following consultations in primary care, are referred by their GP to their designated Regional Fertility Hub for assessment and investigation. Before making a referral, the GP will provide appropriate advice and information on lifestyle factors, carry out relevant tests and examinations, and undertake any necessary initial interventions. The GP must also be satisfied that the couple has been trying to conceive naturally for an adequate period of time. The specific access criteria to avail of services provided at a Hub are less stringent than those required to be met in order to qualify for free assisted human reproduction (AHR) treatment.
Referrals for publicly-funded, privately-provided AHR treatment – including IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) and IUI (intrauterine insemination) – commenced in September 2023, subject to patients meeting the criteria agreed by my Department and the HSE. The access criteria were developed by a multi-disciplinary group, with reproductive medicine expertise and followed consultation with experts in the field along with a review of the international evidence. These criteria are in keeping with those applied in other jurisdictions.
The terms of the publicly-funded AHR treatment initiative are underpinned by the primary policy principle of supporting couples experiencing fertility issues and, most specifically, those who have been trying unsuccessfully to conceive naturally at the time in question.
Just over 4,600 couples to date have been referred by a Reproductive Specialist Consultant for AHR treatment, following extensive investigations and/or secondary level treatment within the Regional Fertility Hubs. Furthermore, the Hubs have successfully and directly managed thousands more patients presenting with fertility-related issues who have been referred by their GP. Not all couples experiencing fertility challenges actually require such advanced and invasive interventions as IVF. In this regard, it should be noted that IUI represents a significantly less invasive and less complex form of treatment which can prove to be very effective for certain cohorts of patients.
There are complex regulatory and clinical issues to be considered in respect of certain categories of AHR treatment. In the case of treatment involving the use of donated gametes – whether by opposite-sex couples, same-sex couples, or single women – there is regulation at European level concerning the quality and safety of procedures involving donated gametes. Furthermore, the Children and Family Relationships Act 2015 deals with matters relating to parentage and the right to identity of donor-conceived children arising from such procedures. Nevertheless, there are a number of further clinical and regulatory requirements regarding the donation of gametes and the use of such gametes which are being considered.
Notwithstanding the above, extensive consultation between Department officials, colleagues in the HSE, and relevant specialists in the field of reproductive medicine on this matter is continuing, including in respect of examining the position in other jurisdictions regarding publicly funding such treatment and the consideration of additional funding requirements which may ensue from such an expansion of the initiative.
It should be noted that supports previously available to patients who access IVF, or other AHR treatment, privately, whereby tax relief on the costs involved can be claimed under the tax relief for medical expenses scheme, continues to be provided.
In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. The annual cost to the State of the financial support for these medicines is far from insignificant.
I want to reassure you that 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 then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the most effective deployment of finite public resources.
Finally, it is important to note that the principle of equal access underpins the development of all legislative and policy measures in the area of AHR. In terms of the publicly-funded AHR treatment initiative specifically, any terms that have or will relate to the provision of donor-assisted human reproduction treatment, for instance, shall apply equally, irrespective of whether the intending parents are a same-sex couple or an opposite-sex couple, or if there is a single intending parent.
