Michael Collins criticises delay in free HRT rollout

Last October, former Health Minister Stephen Donnelly announced that hormone replacement therapy would be made free, which was widely welcomed. However, despite the scheme being scheduled to roll out in January, it has yet to be implemented, leaving women to continue paying for their medication. The Irish Pharmacy Union has highlighted several issues in sufficient communication from the Department of Health, no IT system for the pharmacist's reimbursement and no fixed date for the scheme's commencement. Additionally, it looks like the scheme excludes GP consultation fees and pharmacy disclosing charges, leading to criticism that the term free HRT is very misleading. HRT in Ireland typically costs women between €30 and €70 per month, amounting to around €840 annually. The scheme was supposed to alleviate this financial burden for women experiencing menopause. Furthermore, the cost of getting a prescription from a GP for HRT includes a GP visit fee of €50 to €70, and some pharmacies charge a dispensing fee of €5 to €10. Pharmacists themselves have contacted me and also raised several concerns regarding the free HRT scheme. These concerns underscore the need for clear communication, a robust IT infrastructure, and a well-defined implementation plan to ensure the scheme benefits those in need. Pharmacists flagged problems with the scheme from the time it was first announced, particularly the misleading name, free HRT, which has caused confusion for patients who thought it would cover all costs, like the free contraception scheme. Patients still have to pay for GP consultations and pharmacy dispensing fees, significantly adding to their costs. In hindsight, calling it a free scheme was a bit of a long shot. Hormone replacement therapy has significant benefits and impacts on women's lives. It can alleviate symptoms of menopause, such as hot flashes, night sweats and mood swings, improve bone density, and enhance overall quality of life. Women undergoing HRT often experience increased energy levels, better skin condition, and improved emotional well-being. In Ireland, according to one report, 78 per cent of women report that menopausal symptoms interfere with their daily activities, and 31 per cent of women use HRT to manage these symptoms. The benefits highlight the importance of making HRT accessible and free, as promised. Time and time again, we have heard the words, more menal, and equality for women, here in the Dáil. While I fully support women, I suggest that instead of merely talking about helping them, we should take concrete actions to support them. This scheme was supposed to make life easier for women, but as we know, it is not as straightforward as we were led to believe. For women, the choice between paying essential bills, such as the ESB bill, or covering the ever-increasing cost of food, takes precedence over their own health needs. This should not be the case. Tonshire, given these delays and the financial burden on women, can you provide a clear timeline for when the HRT scheme will be implemented, and detail the steps being taken to resolve these issues. Tonshire? Tonshire? Thanks very much to Deputy Collins for raising this important issue. I should just say, in relation to the comments a bit, I am very proud of a lot of the work we have done together in this House on a cross-party basis, often to try and make progress in relation to women's reproductive health, whether that is around contraception, whether it is around repeating the Eighth Amendment or a number of other important steps that we took together to make progress for women's health. And I accept we have a lot more to do. When I was Minister for Health, we established a new taskforce on women's health that has been working through ever since with quite a number of outcomes. But let me say this too, Deputy, you are quite right that there is understandable frustration, anger, I would say, from many around the country that this measure has yet to be fully implemented. And I want to assure the House that my colleague, the Minister for Health, Minister Jennifer Carol MacNeill, is working very intensively on this issue. In fact, we discussed it as recently as yesterday. I know she has had a number of direct meetings herself with pharmacists, with their representative body to try and get this matter over the line. And in addition to that, the Department and the HSE has also engaged extensively with the Irish Pharmacy Union in relation to the practical rollout of the measure. This measure matters, it matters for the reasons you have outlined. Even operational, the measure will cover any HRT medications and products which are reimbursable by the HSE which have been prescribed for the purpose of alleviating the symptoms of menopause. Reimbursement supports for the new HRT measure will be available to participating pharmacies from the date the measure formally commences. Minister Carol MacNeill and officials in the Department are actively engaged in the matter. They want to see this introduced as an absolute priority and I suppose I would ask today for everybody involved in this, rep bodies, the department, the HSE to let's all have a bit of give and take here to try and get to a point where this scheme can actually be activated once and for all in a way that absolutely supports our pharmacists, the great work that they do in communities right across Ireland. I would just say in the time available to me I do think progress has been made on women's health over the course of the last number of years. It became very clear in the work of the women's health task force that menopause was a neglected aspect of women's health and that that led to an increasing focus on providing assistance to those experiencing menopause under the women's health action plan. This has included a GP clinical lead for women's health established in 2021 to lead on the improvement of women's health supports in the community, a development of a new menopause theory course for GPs and for GP trainees via the Irish College of General Practitioners, a development of a quick reference guide on menopause for GP and practice nurses. The It's My Time campaign was also launched in partnership with Sport Ireland aimed at encouraging women over 40 to increase physical activity levels which can also be helpful in managing symptoms of menopause. We also saw the launch of the first ever national menopause awareness campaign, a second phase of that campaign now in place as well, and we have six specialist menopause clinics now open for women who have complex experiences of menopause requiring specialist care. A lot more work that we need to do in this area, but I do hope these are strong signs of our commitment to the area and delivering the free HRT will be the next important step. Thank you, Tanishda. Tanishda, as I said previously, last October the women of this country were promised free HRT, with implementation set for January. We are now into April, a number of months later, and we are nowhere near a date as such as the winner's start. However, this is not, as I say, yet accord. It is incorrect for the Minister to place the blame on the Irish Pharmacy Union. The delays are on the side of the Department of Health. Many people are contacting pharmacists, expecting prescribed medication to be free under the assumption that the scheme has already been implemented by the Government. It is very unfair to blame the pharmacists for this confusion. To be honest and fair to the women of this country, when will this scheme be rolled out and will it be entirely free? Thanks very much, Deputy. I want to be very clear. I am certainly not, and I hope no one in Government is, and I haven't heard anyone in Government doing this, and I know the Minister for Health certainly doesn't blame the pharmacists at all. The pharmacists have a very important role to play, and in fact, in our programme for Government, we commit to wanting to see an expanded role for pharmacists and a new pharmacy contract, because I do believe when properly and robustly financially supported, there is a huge potential for pharmacists to do more, and I know that from calling into them right across the country. So no blame game here at all. But what there is, is a new Minister in a new Government determined to get this issue over the line. I suppose I am just asking everybody involved, including the pharmacists, to let's all have a little give and take here, to try and reach a resolution very quickly. There is a lot of active engagement going on. I don't want to say anything to be disrespectful to that process, but I am hopeful that this issue can be brought to a speedy resolution. I think it is important that it is. I accept it is going on too long. I accept women expected the measure to be in place before now, and it does need to be brought to a finality, and that is the Minister's priority.