While barriers to accessing contraception do exist for some people in Ireland, the vast majority of people can and do access contraception without any difficulty and contraception use in Ireland is high and stable, according to the Report of the Working Group on Access to Contraception.
Where barriers exist, they include lack of local access, cost, embarrassment, inconvenience and lack of knowledge.
However, the evidence suggests that there is not a widespread affordability issue, with only 3% of respondents in the Irish Contraception and Crisis Pregnancy Study 2010 identifying cost as a barrier to contraception.
The report said that the impact of cost was, however, possibly more significant in terms of behaviour (i.e. choice of contraceptive) rather than access per se. Simply making contraception free to the user was not necessarily a solution, and it was essential that any policy proposal focused on accessibility, education and workforce capacity as well as cost.
The costs of providing a State funded scheme (based on the existing GMS service) to women aged 16-44 is estimated at €80-€100m. There was potential for some savings in relation to the avoidance of unplanned or crisis pregnancy, but it was unlikely that a universal scheme at no cost to users could be justified from a cost-benefit perspective, given the opportunity cost and the likelihood that much of any spending would simply displace or substitute private expenditure without any healthcare gain.
The report said the justification for any scheme would therefore have to rest on social or societal considerations rather than economic ones.
Health Minister, Simon Harris, established the Group earlier this year to consider the policy, regulatory and legislative issues relating to enhanced access to contraception, following the recommendation of the Joint Committee on the Eighth Amendment.
Publishing the report, the Minister said, “In 2018, more than 409,300 condoms and 288,000 lubricant sachets were delivered through the National Condom Distribution Service to organisations working directly with people at increased risk of unplanned pregnancy or STIs. Later this year, we will expand this service and introduce vending machines across third level colleges to increase the distribution of free condoms and further promote safer sex among young people.
“This report provides us with a clear overview of the challenges involved in providing free contraception but also a clear pathway to doing so. I strongly believe cost should not be a barrier to accessing contraception.”
The Minister acknowledged that the cost to the state of introducing a free contraception scheme would be significant and welcomed the report’s consideration of other options to reduce the costs involved in accessing contraception.
“It is important to note that the report says that there are considerations beyond the economic that should be taken into account when developing policy in this area, and this is something with which I wholeheartedly agree.”
He said he intends to further consider the report and to ask the Oireachtas Health Committee to examine it.
The Working Group was established in April 2019 and consisted of officials from relevant policy areas within the Department of Health.