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No money in next year's budget for free contraception, committee heard

A recent report recommends that free contraception rollout should target young women first.

LAST UPDATE | 27 Nov 2019

THERE WAS NO money allocated in Budget 2020 for a free contraception scheme, a health committee heard earlier today. 

The Joint Committee on Health heard today that despite access to free contraception being a recommendation made by the Oireachtas Committee on the Eighth Amendment, the programme is not likely to be rolled out until 2021.

Health Minister Simon Harris said previously he was hoping to introduce the programme this year.

Andrew Conlon, principal officer in primary care policy from the Department of Health, said there was little to be gained from rolling it out this year. 

“It was a very difficult budget in the context of a no-deal Brexit, and indeed the national finances were under pressure in that respect, and secondly the money that was available for health was prioritised towards mental health, community services, and so on,” he said.

“I think as the report makes clear, there’s an awful lot of detailed policy work, and legislative work, to be done to advance the scheme.

“So, and in that sense, there would be very little to be gained by allocating money in budget 2020, as the odds are it would sit just there.

The Irish College of General Practitioners (ICGP) recommended rolling out free contraception for all women earlier today.

The Department of Health has been advised that instead of giving everyone free access to contraception, that a State-funded scheme should be focused on providing free contraception to young women first.

The government established the working group in April this year to consider policies and legislation around improving access to contraception after the Oireachtas Committee on the Eighth Amendment recommended free contraception. 

The report found that local access, cost, embarrassment, inconvenience and lack of knowledge were among the barriers to accessing contraception.

It highlighted that young women and vulnerable groups should be prioritised when giving free contraception.

However, Dr Mary Short, Director of Sexual and Reproductive Health at the ICGP, makes the case that from the experience of GPs, even those that have the education and knowledge “are at risk of making poor choices due to the initial cost outlay”. 

In her opening statement to the Oireachtas Health Committee, Short states that a pack of condoms may seem an inexpensive option in the short-term where a Long Acting Reversible Contraceptive (LARC) such as a contraceptive coil or implant “would be the better option”.

She states that a pack of condoms costs €5 – €15, whereas a coil costs approximately €200 but lasts five to 10 years, and therefore should be considered for free rollout to all women under the proposed new measures. 

Women in their forties believing they’re precluded from pregnancy

Short told members of the committee today that women’s contraceptive choices change depending on the needs of the person or couple. 

Making the case for better education for women, she stated that those in their mid to late forties are in need of more information stating that it is GP experience that some “erroneously believe that age, infrequent intercourse etc, precludes her from a pregnancy”.

In order to ensure a range of contraceptive options are available to women, for free, she states that the ICGP would like to expand the training and upskilling of doctors in coil and implant provision.

She states that while in economic terms this is an upfront investment, and has long-term benefits as such methods of contraception are more successful than the pill or condoms. 

Andy Conlon, Chair of the Working Group on Access to Contraception, will outline that as a result of the report, there are a number of options to consider. 

These include: 

  • Universal state funded contraception scheme based on the GMS scheme, but including the copper coil
  • Expansion of General Medical Card scheme as it relates to LARC to all women
  • Phased approach to the introduction of a free contraception scheme, beginning with younger women in the 17-24 age range. 

Cost of free contraception to the State

While there is considerable support among stakeholders for the introduction of a universal, State-funded scheme for contraception, the cost of introducing
such a scheme is estimated at €80 million to €100 million. 

“This is a significant sum and leads naturally to the question of whether such investment would represent the best use of resources,” Conlon’s says in the opening statement. 

In terms of accessibility, the report also examined the potential role of community pharmacists in prescribing contraception.

Having pharmacists distribute contraception aims to balance the need for easier access to services, with the report recommending that oral contraceptives could be prescribed for a 12-month period to improve accessibility while maintaining patient safety and reducing costs.

With reporting by Press Association.

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