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The current eligibility criteria for the free IVF scheme is 'too conservative', says Donnelly. Alamy Stock Photo

First baby born through state-funded IVF scheme with eligibility criteria expansion on the cards

Health Minister Stephen Donnelly says over 1,000 couples have been referred through the publicly funded scheme in the last year.

OVER 1,000 COUPLES have been referred for free fertility treatments, such as in-vitro fertilisation (IVF), since the government launched the country’s first ever publicly funded scheme last September. 

Health Minister Stephen Donnelly said the state-funded scheme passed two important milestones this week with over 1,000 couples being referred to clinics for free IVF, intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI).

Noting another important marker, the minister said the first baby conceived through the programme has also been born. 

“We’ve just had our first live birth from IVF. It’s fantastic, new life,” Donnelly said. 

Eligibility criteria changes 

Speaking to The Journal, the health minister said he wants to expand the criteria to allow more people to avail of free IVF supports which could include the widening of the age brackets, a wider definition of the length of a relationship or increasing the number of cycles couples can avail of for free. 

Since last September, one publicly funded IVF cycle has been available to couples that meet certain criteria, which includes limits on maximum age, body mass index (BMI), and the number of existing children a couple have. 

While the announcement of the scheme was welcomed last year, there were criticisms about the narrow scope of the criteria, which resulted in cohort of people, such as single people and those using donor material unable to avail of the free supports. 

Donnelly told The Journal that the current criteria is “conservative” and he plans to widen it so as to include more people. 

At the launch last year, the minister predicted that around 3,000 couples would avail of the scheme, though he acknowledged that as it was the first free fertility treatment programme in the country, the demand was difficult to predict. 

“We’re at a run rate now of about 1,500 [couples] annually,” said Donnelly, stating that he believes the numbers will rise as more people become aware of the government funded scheme.

“Will it go up to 3,000? Let’s wait and see,” he said, stating that his department has now been asked to carry out a review of the scheme over the last 12 months. 

“I want to widen the criteria. The clinical advice that I got at the start, the team themselves said ‘this is conservative’.

‘Too conservative’

We had a table of all the different eligibility criteria and where different countries are, and ours was conservative. Too conservative for my liking.

“But the clinical point made back to me was that we had never done this before, let’s start and get it right,” said the minister. 

Donnelly said there is now room to expand the programme and the review due to be carried out “quickly” in September will determine where criteria changes would be most warranted. 

He said he has asked the department to outline in the review how the criteria might be expanded and if the department can fund it, either from within the allocated budget and outside of it. 

Donor assisted material 

One area the government will expand the scheme to, regardless, is those using donor assisted material.

Currently a single person, same-sex couples, or hetrosexual couples who require donor eggs or sperm are not be eligible for the scheme.

With the passing of the Assisted Human Reproduction legislation through both Houses of the Oireachtas in June, action can now be taken by government to address this issue. 

The minister acknowledged that when the state-funded IVF scheme was launched last year some people were “very understandably disappointed” as no donor assisted IVF was state-funded.

“I wanted to move on it straight away. I got a very clear clinical view back from the HSE that it’s not a regulated area,” he said.

However, the minister said with the passing of the AHR bill, and the setting up of a new authority that will oversee the regulations, an amending piece of legislation is to be introduced to expand the criteria for donor assisted IVF by the end of the year. 

“I want to go further,” the minister stated, adding that his department will now gather feedback from the six regional fertility centres which have been in operation over the last year. 

“I think we will listen very carefully to the frontline clinicians,” he added. 

Age restrictions

One area which was criticised last year was the age restrictions put in place. 

Under the Irish scheme, the woman should be a maximum age of 40 years plus 364 days at the time of referral to the regional fertility hub.

For the man, the maximum age is 59 years plus 364 days at the time of referral.

By comparison, there are no legal age limits in place in Finland, Germany, and Norway, while other countries have higher age restrictions in place when it comes to accessing fertility treatment. 

When asked if there could be changes to the age requirement, Donnelly said: 

“I want eligibility to increase. I don’t want to prejudge. We have to be led by the science on this, and we have to be led by the doctors. So I want to let them do their work and come back, and if they recommend on age or number of living children, or length of relationship, or whatever it is, then we’ll look at that.”

Second round of free IVF

“The other big one that people have asked for is a second round [of IVF]. We only fund one round of IVF, three rounds of IUI,” he said, stating that moving to a second round needs to be reviewed.

Donnelly said he needs to ascertain if rolling out another free round of IVF would jeopardise the ability to expand the eligibility criteria, for example.

“I think we need to look at all of that in the round,” he said. 

The minister said it was a “radical move” to launch the scheme by striking a deal with the private clinics that were already operating the service, stating that he didn’t believe the government could ask people to wait while the state built its own capacity.

The first state-owned clinic in Cork will begin IUI in the first quarter of next year, before moving to IVF, he confirmed. 

“The idea that we would have asked all of these couples to wait for five years so that we could do it publicly” would not have been acceptable to him, said Donnelly. 

Waiting lists at the Rotunda

When asked about wait times for couples, the minister said the scheme has been running smoothly, but said there has been a “hiccup” at the Rotunda clinic with the waiting list, due to historical issues around the ownership and operation of the service from the hospital. It is understood that it relates to delays in the consultant referral to a private clinic, with some waiting months for the matter to be resolved. 

“I’m not satisfied with it. It’s too long. I’ve raised it with the department, and we’ve discussed it the National Women and Infants programme and there is an identified capacity issue there that is being addressed. But the timelines are too long. I’m not satisfied with them. We can’t have people waiting. There were some concerns that people might age out [of the scheme]. They don’t age out. The age is from your GP referral,” he confirmed. 

“For the woman, time matters, right? And if she is already 40 years of age, then she needs rapid access. There is an issue in the Rotunda. We know what the problem is and we’re sorting it out,” he said. 

Speaking about reports that the government plans to roll out free access to HRT for all women, the minister said it is a “central” pillar for him. 

“It’s something that all women may want access to… it’s core to women’s healthcare. We can’t have a situation where any woman in Ireland feels they can’t afford access to HRT… I think universal access to it is the way to go. I’d like us to fund universal access. The department are working through further detail on that,” he said. 

He stated that while there isn’t a competition between HRT and IVF in terms of funding, he would like to be able to expand the eligibility criteria for IVF within the existing funding package as it would protect new development funding for other things, such as free HRT for everybody.

“I want the IVF criteria to be in line with Europe and we’re still conservative,” he concluded. 

 

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    Mute @mdmak33
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    May 2nd 2018, 12:58 PM

    The public have lost trust in this goverment.

    341
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    Mute Shane Fleming
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    May 2nd 2018, 1:56 PM

    @@mdmak33: It’s more the public have lost trust in the HSE. Ministers are mere puppets controlled by the secretaries generals.

    113
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    Mute Stephen Adam
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    May 2nd 2018, 2:00 PM

    @Shane Fleming: The public haven’t lost trust in anything. Just look at the polls – FGLeo riding high still. The public don’t care about this. Not really.

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    Mute Paul Fahey
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    May 2nd 2018, 2:26 PM

    @Stephen Adam: riding high? They are in early 30’s, which means over two thirds have no intention of voting for them.

    52
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    Mute Stephen Adam
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    May 2nd 2018, 2:28 PM

    @Paul Fahey: given the fractured nature of our politics they’re still the most popular party in the country. LV is the most popular leader since Bertie.

    FFFG have probably 50% of the vote. So nothing changes. Homelessness house prices Garda corruption now this – won’t make a difference.

    23
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    Mute Dave Doyle
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    May 2nd 2018, 3:31 PM

    @@mdmak33: What is there to trust about a corrupt golden circle where they all look out for each other and to hell with everyone else.
    The Times are running a story today that tells us Tony O’Brien joined an American company as a board member on a lucrative contract. The chairman of the compant has fundraised for Leo and is chairman of the board of Ireland East Hospital, the countries largest hospital group and the Mater hospital.
    There’s conflicts of interest written all over this corrupt government and their cronies.

    50
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    Mute Stephen Adam
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    May 2nd 2018, 12:58 PM

    Ah sure look – won’t the tax payer foot the bill? Sure it’s grand.

    When do we see some sackings? Some pensions stripped? Some more resignations?

    When is there actual accountability for the appalling negligence and ass covering?

    When the tax payer has to pay out someone’s head has to roll.

    254
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    Mute Leroy
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    May 2nd 2018, 1:13 PM

    @Stephen Adam: Its easy spending somebody’s else money you see

    114
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    Mute Tom Purcell
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    May 2nd 2018, 1:56 PM

    @Stephen Adam: One word answers all your questions: “Never!”

    39
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    Mute wattsed
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    May 2nd 2018, 1:15 PM

    Wait, he doesn’t know the full numbers – but the reassessments will be completed by the end of May. How was that time frame therefore arrived at ?
    Has there not been enough incompetence under FG, now and in the past, for FF to withdraw support and revisit who we want to represent this country, whoever that may be. What else is going on that we haven’t been given transparency on ?

    112
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    Mute David Knight
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    May 2nd 2018, 1:40 PM

    So after all the hand-wringing and crocodile tears, the fake apologies and the firm promises of action, (as opposed to actual action), they are now saying they still don’t know the full facts. What an admission! It’s clear that the chain of command is simply not working within our public services. Some of the blame may lie with operating in a highly unionised environment, where the civil servants are so cocooned from reality, that they just don’t give a damn, and there is no failing that can ever have any impact on their situation. But what is stopping a minister from breaking the chain of command and going to the coalface and get his answers for himself? What is stopping the government from creating new legislation that brings in accountability? What’s to stop a minister from introducing criminal negligence and charging people found to be accountable, where loss of life is proven?

    82
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    Mute Irish Bob
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    May 2nd 2018, 2:21 PM

    Leo wants time !!! this case is going on since 2011, 7 years, he was a health minister and now Taoiseach .. And if Leo and Simon did not know ( i dont believe them ) then they should resign for not knowing abou State going to war with that poor woman for the last 7 years

    77
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    Mute Shane O Malley
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    May 2nd 2018, 1:06 PM

    prime ministers,heads of departments,ministers, td’s, garda commissioners, does not matter who you are on Irish gov payroll, does not matter how Incompetent, does not matter how much damage inflicted on innocent people, here is your pension & lump sum off you pop,,,GROSS

    161
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    Mute Liam McGowan
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    May 2nd 2018, 10:17 PM

    @Shane O Malley: Agreed Shane. Same with the bankers, auditors and those who inflicted real hardship, even death on the general public. The elite never pay.

    8
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    Mute Eugene Walsh
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    May 2nd 2018, 1:04 PM

    This country is hazardous. If it’s not the cops , crap road infrastructure, shocking health service…it’s the governments complete incomoetency.

    The government runs this state and is responsible for it’s people considering that tax they collect .

    133
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    Mute Dave Doyle
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    May 2nd 2018, 1:51 PM

    Redress isn’t much to those that have died, and not a lot of good to those women whose lives are shortened by government incompetence and couldn’t care less until caught attitude.

    71
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    Mute Irish Bob
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    May 2nd 2018, 2:49 PM

    Copied from Journal.ie .. Proves Leo knew more

    http://www.thejournal.ie/varadkar-cervicalcheck-3988626-May2018/#comment-7169130

    Dara O’Brien
    4y
    7hours ago

    @gregory: Dail debate is here if you want to read it – from 2008, Leo is a TD since 2007 and as a doctor, he would have been well aware of this debate.

    “The method of screening done by Quest Diagnostics is not up to the same standard as the public labs in Ireland — this means that more Irish women will die” Sinn Féin’s, Aengus Ó Snodaigh warned the Dáil on May 29, 2008.

    “Quest has won the tender to analyse 300,000 Irish smear tests a year, but consultant pathologists from the Coombe Women’s Hospital, St. James’s Hospital and St. Luke’s Hospital in Dublin, and University College Hospital in Galway stated that missed cases would arise because the diagnostic rate of pre-cancerous cells at Quest Diagnostics in the US is 30% less than that of Irish laboratories.

    This concern has been echoed by the Irish Association for Clinical Cytology, IACC, which has expressed its disquiet at the decision to award the contract for cervical screening services to Quest, thereby excluding Irish laboratories. The IACC says this decision will have serious implications for the long-term quality of the cervical screening programme”

    He continued

    “The Irish Association for Clinical Cytology states that Irish laboratories provide a quality screening service as evidenced by comparison of incidence and mortality rates to other European countries…

    There is significant concern that testing for this screening programme has been placed in the hands of a multinational giant that has been convicted of fraud in the US…Janette Byrne of the Patients Together campaigning group, said: “We would definitely question why public money is being given to a company that has been investigated for acting fraudulently in another country.”

    It seems the Minister for Health and Children would rather listen to corporate executives in the private health business than to health experts and patients in Ireland. Not only are our health services being privatised, but jobs and services are being exported. Trained and trainee laboratory technicians in Ireland are being written off by this decision and many will have to emigrate to find work in the future”.

    He added:

    “During questions on the issue of the cervical cancer screening programme last October, my colleague, Deputy Ó Caolain, asked the Minister if it was preferable that the testing labs should be here. The Minister replied: “Yes, ideally we must have our own laboratory facilities in Ireland.” This does not seem to be the case now.

    I have been contacted by a medical scientist, a constituent of mine, who has raised her concern at the outsourcing to Quest Diagnostics…The HSE has a sorry history with its privatisation agenda and she does not want to see it happening with laboratory services. She concluded by stating: “As a woman and mother of two daughters I am horrified to think that the standards of screening cervical smears are going to be reduced unnecessarily and put us at risk.”

    The Minister must listen to such expert voices — those involved in the service, those working in the service and the patients who have to use the service”.

    http://oireachtasdebates.oireachtas.ie/debates%20authoring/debateswebpack.nsf/takes/dail2008052900007?opendocument

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    Mute Tom Purcell
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    May 2nd 2018, 2:09 PM

    The government needs to do something no government since the formation of the state has ever done – start sacking the [thousands of] under performing civil/public servants. They need to stand up to the vested interests (includnig the unions) and serve the people of Ireland, not just the select few.

    Can our politicians – regardless of their loyalties – not see that the public is sick and tired of one branch after another of the civil/pubic service failing, being corrupt, wallowing in incompetence, holding the public to ransom…. a number of senior people need to go.

    46
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    Mute Stephen Adam
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    May 2nd 2018, 2:19 PM

    @Tom Purcell: If the Public were sick and tired of it FG would be getting hammered in the polls and so would FF.

    They’re not. The public don’t care. Reform and sacking corrupt or negligent civil servants simply isn’t something the public give a hoot about.

    14
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    Mute Irish Bob
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    May 2nd 2018, 2:24 PM

    @Stephen Adam: Polls ? who does these polls and we never seem to get a breakdown of how many are polled etc. like the useless Claire Byrne polls of 1000 people which is a very small percentage of the population.
    Agree that FF have alot to answer for proping up this shower, they should pull down this Goverment and let the people of Ireland choose

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    Mute Stephen Adam
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    May 2nd 2018, 2:38 PM

    @Irish Bob: so it’s your position bob that the polls are wrong? And that actually – who? Sinn Fein? Are actually ahead?

    I loath FFFGLab – the scandals and mismanagement are a disgrace. But let’s be realistic. The majority of the country will return these parties to office.

    10
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    Mute Dave Doyle
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    May 2nd 2018, 3:19 PM

    @Stephen Adam: Try polling women. Not just “suitable” candidates.

    9
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    Mute Stephen Adam
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    May 2nd 2018, 3:27 PM

    @Dave Doyle: I’m not sure what that means Dave. Are you suggesting the polls are doctored? If that were true we wouldn’t have had decades of FFFG mismanagement. But we have.

    4
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    Mute Kirk Loco
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    May 2nd 2018, 6:18 PM

    @Stephen Adam: You mean to tell me you actually believe the polls are managed accordingly without any doctoring of numbers?

    You leave that comment under a news story about more shameful scandal in Ireland?

    The politicians of this state, the judicial system, law enforcement and medical services are all corrupt to the core and a disgrace!

    6
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    Mute Stephen Adam
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    May 2nd 2018, 8:00 PM

    @Kirk Loco: I believe information which supports the facts. When the polls say FF FG have 50% of the vote and they also have 50% of the Dail – and we’ve been electing them for a century – well yes I believe the polls.

    If the polls said the social democrats and Renua were going to take 50% or the next Dail I wouldn’t believe them.

    1
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    Mute Trevor Hayden
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    May 2nd 2018, 1:47 PM

    Will FG handle it as well as the church redress?
    I wouldn’t hold my breath.
    Fg or FF couldn’t care less.
    No faith in either.

    56
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    Mute Anthony Gallagher
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    May 2nd 2018, 2:30 PM

    Apologies and a redress scheme ,anything from fanning the flames of public discontent .varadkar is up to his neck in this ,he has been flip flopping through this already tired administration .he is the same old plastic politician we have become accustomed to in ireland ,he will i presume cap his tenure off by offering another big goodie bag at the next election .Whatever happened to the great democratic revolution ,gombeens

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    Mute SilentFugitive
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    May 2nd 2018, 3:42 PM

    @Anthony Gallagher: Look at the photo, even now in this dark dank place Irish politics finds itself in – he is thinking about image, surrounding himself with women. Two to the left and two to the front. It’s all about presenting the right image and the optics have to be positive. That speaks volumes to me. Bigger shame on the pawn TDs for allowing themselves to be used in that regard.

    26
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    Mute Anthony Gallagher
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    May 2nd 2018, 4:31 PM

    @SilentFugitive: agree ,i think if leo had any real leadership qualities he would be standing or sitting on the front row .he looks very much like he is being protected .when your in command command and to me that is taking pole position .leo would appear to have a lot of self doubt .he is being paid a very handsome salary its time he proved to the country he is worth it .

    13
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    Mute AJ
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    May 2nd 2018, 2:10 PM

    What did you know slimeball???

    17
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    Mute Declan Carr
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    May 2nd 2018, 3:34 PM

    Say nothing we just might get through this. Don’t mention money, only the only the cost to go back and have it done. Don’t forget to say we were never told or I cant remember.

    16
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    Mute Kevin Slater
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    May 2nd 2018, 5:31 PM

    Rather than paying off the women, maybe the former minister for health might instigate a proper inquiry?

    11
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    Mute francis dowling
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    May 2nd 2018, 8:35 PM

    If it wasn’t for the courageous Vicky phelan highlighting the way she was horribly treated by the state it would of been business as usual for Leo and his incompetent government what the people don’t know won’t hurt them, shame on you Leo

    9
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    Mute ForeverFeel1ng
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    May 2nd 2018, 11:38 PM

    Too many Administrators in the HSE. There needs to be a purge. Plain and Simple.

    4
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    Mute Declan
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    May 2nd 2018, 8:13 PM

    What a disgustingly hollow and self serving Bass turd this clown is, people have died for Christ’s sake, what where the reasons behind these Laboratories getting this work? Who organized the deal? Was this companies numerous class actions considered during the tender process? Redress ? That won’t bring people back, money hasn’t and never will clean up the middle management/civil servant cesspool that is the HSE?! This horribly inexperienced unelected leader of the Irish people has been a Doctor and Minister for health!? I’m guessing this clown became a politician to circumvent his obvious hippocratic oath failings. Ethical Pledges and behaviours!? Do yourselves a favour don’t associate this criminal with either and don’t look in the Dail for them either. Disgusting liar.

    10
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    Mute Michael Donovan
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    May 3rd 2018, 9:35 PM

    How about a redress scheme for those whom we’re held in cervitude in all of Ireland’s “Holly Labour Camp’s” concidering you get nothing for LPT these day’s love to see the council’s pay this over as componsation,,,for the brutality shown by state and religouse orders.

    1
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