Last October, the former Minister for Health, Stephen Donnelly, announced that hormone replacement therapy, HRT, 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, including insufficient communication from the Department of Health, no IT system for the pharmacists' reimbursement and no fixed date for the scheme's commencement. Additionally, it looks like the scheme excludes GP consultation fees and pharmacy dispensing charges, leading to criticism that the term "free HRT" is misleading.

HRT typically costs a woman between €30 and €70 per month, amounting to as much as €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 have contacted me and 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 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. Maybe, in hindsight, calling it a free scheme was a bit of a long shot.

Hormone replacement therapy has significant benefits and impacts women's lives. It can alleviate symptoms of menopause such as hot flushes, 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% of women report that menopausal symptoms interfere with their daily activities and 31% use HRT to manage these symptoms. These benefits highlight the importance of making HRT accessible and free, as promised.

Time and again, we have heard the words "more" ,"mná" and "equality for women" 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. Given these delays and the financial burden on women, can the Tánaiste provide a clear timeline for implementation of the HRT scheme and detail the steps being taken to resolve these issues?

I thank Deputy Collins for raising this important issue. I should say about the comment on mná na hÉireann and the likes, I am very proud of a lot of the work we have done together in this House, often on a cross-party basis, to make progress on women's reproductive health, whether around contraception, repealing the eighth amendment or a number of other important steps. I accept we have much more to do. When I was Minister for Health, we established a new task force on women's health. It has been working through ever since with quite a number of outcomes.

The Deputy is 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. My colleague, the Minister for Health, Deputy Carroll MacNeill, is working intensively on this issue. In fact, we discussed it as recently as yesterday. She has had a number of direct meetings with pharmacists and their representative body to try to get this matter over the line. In addition, the Department and the HSE have engaged extensively with the Irish Pharmacy Union on the practical roll-out of the measure.

This measure matters for the reasons the Deputy outlined. When operational, it will cover any HRT medications and products that are reimbursable by the HSE and 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. The Minister, Deputy Carroll MacNeill, and officials in the Department are actively engaged in the matter. They want to see this introduced as an absolute priority. I would ask everybody involved in this today - representative bodies, the Department, the HSE - to let us all have a bit of give and take in order to get to a point where the scheme can be activated once and for all in a way that supports our pharmacists, whose great work in communities across Ireland I acknowledge, and, crucially, fulfils the policy objective of making sure these HRT measures are funded and available to the women of Ireland.

Progress has been made on women's health over the past number of years. It became clear in the work of the women's health task force that menopause was a neglected aspect of women's health. This 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; development of a new menopause theory course for GPs and GP trainees via the Irish College of General Practitioners; and development of a quick reference on menopause for GP and practice nurses. The "It's My Time" campaign was launched in partnership with Sport Ireland. It was aimed at encouraging women over 40 to increase physical activity levels, which can also be helpful in managing symptoms of menopause. We saw the launch of the first ever national menopause awareness campaign. A second phase of that campaign is now in place. We have six specialist menopause clinics open for women with complex experiences of menopause requiring specialist care. There is much work we need to do in this area but I hope these are strong signs of our commitment to the area. Delivering free HRT will be the next important step.

I thank the Tánaiste. Last October, the women of this country were promised free HRT, with implementation set for January. We are now into April but nowhere nearer a start date. It is incorrect for the Minister for Health 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 the scheme has already been implemented by the Government. It is 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?

I want to be very clear, in that I am certainly not, and I hope no one in government is - I have not heard anyone in government doing this, and the Minister for Health certainly is not - blaming pharmacists at all. Pharmacists have an important role to play. In fact, in our programme for Government, we commit to wanting to see an expanded role for pharmacists and a new pharmacy contract. When properly and robustly financially supported, there is huge potential for pharmacists to do more. I know that from calling into them across the country. There is no blame game here at all. What there is is a new Minister in a new Government determined to get this issue over the line.

I asked everybody involved, including the pharmacists, to let us all have a little give and take and try to reach a resolution quickly. There is a lot of active engagement going on. I do not want to say anything disrespectful to that process but I am hopeful that the issue can be brought to a speedy resolution. 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. It needs to be brought to a finality and that is the Minister's priority.