Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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174. To ask the Minister for Health the estimated full-year cost of funding the extension of free contraception to all women; and the age groups to which this would apply. [43301/24]

Colm Burke (Cork North Central, Fine Gael)
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The free contraception scheme was launched in September 2022, initially for those aged 17-25. It has been gradually expanded and now includes women aged 17-35 from July 1^st, 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 other 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.

It is estimated that expanding the scheme from 36-40 would cost €8m and above the age of 40, costs are approximated at €1m per year age-cohort. The total cost of full expansion is therefore estimated at €23m

The Minister has stated that he is committed to the gradual expansion of the free contraception scheme up to and including the age of 55 (after which, prescription of contraception is not typically clinically recommended). There is no public health based reason to limit the age-range that can access the scheme, rather, its phased introduction was undertaken for a number of reasons, as follows:

• 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 may rise with age.
• 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 increasing the numbers of GPs with the expertise to fit, check and remove coils and implants. It is anticipated that demand for coils and implants will be higher in older age cohorts.
• The National Women and Infants Health Programme are also putting additional training in place for healthcare professionals working in maternity and gynaecology services and in the SATUs.
• 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. A significant number of people in the 17-25 age cohort are still in full time education and dependent on parents and guardians for income, some of whom may not be willing (or, indeed, in some cases, able) to fund prescription contraception.