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The hospital entered into a service level agreement (SLA) with Rotunda IVF after the sale of the clinic — then known as the Human Assisted Reproduction Ireland (HARI) unit — in 2014. The Rotunda has provided €360,000 per annum from ancillary funds for public patients wishing to access IVF. On 3 May, the hospital Board meeting heard that the SLA expired in December 2017, but 12 cycles had been processed in 2018.
The Board discussed a one-year contract amounting to €200,000 and capped at 40 cycles (€4,900 per cycle). “The Master summarised clinical criteria for pro bono patients and outlined pregnancy success rates, which are in line with similar infertility units at 35/40 per cent. No other maternity hospital funds pro bono fertility services,” according to meeting minutes.
The minutes also noted that “the potential charging for extra services, ie, medications/therapies, to pro bono patients is a concern and the insertion of a clause in the SLA to mitigate against this was suggested”, with the Board agreeing upon this action.
“Funding of the RIVF SLA 2018 in the amount of €200,000 for one year was agreed. Should the service exceed this amount, the EMT [executive management team] is to revert to the Board.”
A Rotunda Hospital spokesperson told the Medical Independent that all eligibility criteria are set by the hospital. An estimated 35-to-40 patients will access the funding this year.
“No additional charges for services related to IVF will be levied on the patient without the advance approval of the Rotunda referring consultant,” said the spokesperson.
As these are pro bono patients and primarily medical card-holders, it was felt that “some protection should be afforded to them through the SLA by not exposing them to potential non-essential charges from [a] commercial fertility service”.
The funding arrangement will be reviewed annually.
In Ireland, IVF treatment is not publicly funded. However, to support proposed legislation on assisted human reproduction (AHR), the Department of Health and HSE are working on developing a model of care for infertility. This work includes identifying policy options for a public funding model for AHR treatment.