Introduction of free HRT delayed as Dept of Health rows back on Budget pledge

The delay means menopausal women must continue to pay for HRT products. Picture: Anna Watson

The Department of Health has rowed back on a pledge to give free hormone replacement therapy to thousands of women from this week, the Irish Examiner can reveal.

All the department can tell the women now is that the free HRT will be rolled out “as soon as possible”.

Pharmacists say the frustrating and “disrespectful” lack of planning means it could take months before this happens.

The delay means menopausal women who had been expecting a drop in medical bills this month must continue to pay for HRT products. 

This is despite a pledge in Budget 2025 by health minister Stephen Donnelly to introduce free HRT from January 1.

Stephen Donnelly made a pledge in Budget 2025 to introduce free HRT from January 1. Picture:

Pharmacists have estimated HRT can cost anywhere from €18 to €1,224 annually, with the price depending on the type of medication and complexity of symptoms, as well as other variables.

Tom Murray, Irish Pharmacy Union president, said key elements of the scheme are still not in place.

“There has been absolutely no operational or implementation details agreed; there hasn’t even been discussion as to how the scheme would actually work,” he said. “So nothing has been put in place.” 

Secondary legislation to support a Bill passed in November is required, he said, adding: "That piece of legislation hasn’t even been written yet.” 

The IPU wrote to the department four times between October and Christmas, raising concerns.

“When they do come and talk to us, there will be a significant lead-in time required in terms of how the [new] IT system works,” he said.

This could take “several months”, he warned, adding that the delays are “very disappointing from our point of view".

I think it was actually quite a poor thing to do to say to ladies in this country ‘we’re going to give you something on the first of January but we have no idea how we’re going to do that’.

The scheme still requires menopausal women to pay for GP and pharmacy services, in contrast to the contraceptive scheme, which covers all fees.

Describing this as a “dichotomy of treatment”, Mr Murray said it is “inequitable in our opinion". 

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The IPU also raised clinical queries, saying some “normal patient care and concerns” are not in place. It proposed instead an integrated women’s healthcare plan.

“[This] would provide equity of care to all women in respect of hormonal care, be that for women of child-bearing age or women through to the end of menopause,” he said.

A shared approach would also reduce the need for a new IT system, he noted. 

Mr Murray said pharmacists' frustrations are compounded by delays on other issues.

“We’ve had a 16-year pay freeze,” he said, adding that 10% of pharmacies are losing money.

They want to see “significant progress on pay talks” before the HRT scheme or others linked to a taskforce report are introduced. 

For example, a review of pharmacy fees began in July 2023 but he said they only received a framework document on December 22 last year.

“The word disrespectful of the profession is absolutely my opinion and I just don’t understand the procrastination for 18 months before they even start to have substantial talks. Then they are expecting pharmacists to voluntarily sign up for [the HRT scheme] which has no definition of how it is going work whatsoever,” he said.

Really, they are just putting us on the frontline, explaining to female patients why the Department of Health hasn’t done what the minister promised they were going to do.

A Department of Health spokeswoman told the Irish Examiner “the goal is to introduce this measure as soon as possible”.

It is to continue working with the HSE and IPU, she said, including on “practical implementation of the Health Insurance (Amendment) and Health (Provision of Menopause Products) Bill 2024”.