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THERE IS STILL no agreement between the HSE and the Department of Health on how to make prenatal testing, which can cost couples hundreds of euros, available through the public system.
Non-invasive prenatal testing is an accurate form of screening for chromosomal conditions such as Edwards Syndrome, Patau’s Syndrome, Down Syndrome and other fatal foetal anomalies likely to result in death in utero or in infancy.
The tests are only available privately, except in a few exceptional cases, and cost hundreds of euros.
Research by University College Cork found these tests currently cost between €380 and €650 at private obstetric clinics and at four of the 19 maternity hospitals. Ultrasound clinics and some GPs also offer the tests.
The blood test, accompanied by an ultrasound scan, and is sold under brand names including Harmony and Panorama.
The Journal has previously reported how high financial costs and uneven geographical coverage has presented barriers to expecting parents in Ireland who want to access non-invasive prenatal testing for chromosomal differences.
Correspondence released to The Journal under freedom of information also revealed that in 2023, Dr Cliona Murphy, then-clinical director of the National Women and Infants Health Programme, raised inequitable access to this testing with the National Screening Advisory Council.
The controversy over public-only consultants working in private maternity care in the Rotunda Maternity Hospital has sparked a conversation about what Ireland’s maternity care will look like under the Slaintecare model.
One aspect is around prenatal testing, and whether it will be offered to women through the public system.
Kilian McGrane, the current National Programme Director for Women and Infants Health in the HSE told a recent committee hearing that there was a recommendation in a review done under section 11 of the termination of pregnancy Act that pre-natal testing would be introduced.
“We have developed a proposal on that. That proposal has gone into the Department of Health as part of our ongoing negotiations with it. We do not have agreement on it yet,” he told Labour’s Marie Sherlock.
He said a revised version of the proposal was submitted in the past two months.
“It is not sitting in there for a long time. We have had discussions with the Department back and forth for a period of time,” he said.
A statement from the HSE confirmed there is currently no national publicly funded prenatal testing.
“The introduction of a first trimester aneuploidy screening programme using NIPT plus ultrasound was proposed to the National Screening Advisory Committee (NSAC) in 2021 and again in 2022.
“An independent Review of the Safety and Operation of Section 11 of the Health (Regulation of Termination of Pregnancy) Act 2018 (the Regan Review), also noted unregulated, inequitable access to commercially provided screening tests for aneuploidy (e.g. NIPS), and recommended the establishment of a National Clinical Programme for screening for foetal anomaly,” said the HSE.
The statement went on to say that any decision to introduce a publicly provided testing programme would require a policy decision and an appropriate funding stream.
Sherlock told The Journal that while some hospitals might provide the prenatal testing, others do not, and the cost can be prohibitive if
The Labour TD also said she had concerns that the new national maternity strategy might not be ready until the earliest 2027, stating it is not really “acceptable”.
The negotiations around prenatal testing are ongoing come at a time when Minister for Health Jennifer Carroll MacNeill confirmed to The Journal that her department is currently evaluating the government’s previous ten-year national maternity strategy, which is due to end this year.
The minister said “huge progress” has been made since that strategy was launched in 2015, but she said it is now a very “different landscape in terms of the care and the focus on women [and] putting women at the centre of their own advocacy, putting women at the centre of their experience”.
“We now have so much more happening in terms of women’s health,” said the minister, who added that she wants to reflect the changed landscape in the new national maternity strategy.
Asked if the new national maternity strategy is going to outline what maternity care is going to look like under Slaintecare, the minister acknowledged that women should have the choice of consultant-led care or midwife-led care, but that’s not always the case.
“That’s what we need to get to. We’ve built over the last 10 years a very different maternity landscape, we will build over the next 10 years, a very different maternity landscape. Every public only consultant contract, a consultant that we recruit into the system, will add to that, will take us closer to that,” Carroll MacNeill told The Journal.
“But as with the last maternity strategy that took 10 years to make very considerable improvements, the next one has improvements to make as well, and we look forward to trying to fund, strategize, and deliver that over that period, and I think that’s a reasonable sort of balance,” she said.
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