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'It's a huge source of stress': Women going abroad for IVF hit out at mixed messages over travel restrictions

Hundreds of people travel abroad for fertility treatment every year because they cannot afford it in Ireland, but Covid-19 has further complicated the situation.

THE GOVERNMENT’S MIXED messaging on travel abroad has been criticised by people who need to travel overseas for fertility treatment.

Many people choose to travel to elsewhere in Europe for treatment because the process can be thousands of euro cheaper than in Ireland.

However, people are concerned about the impact Covid-19 travel restrictions, and flights being cancelled, could have on their treatment.

Some people are missing appointments or choosing to delay their treatment, but this is not an option for others – particularly if age is an issue.

There has also been a lack of clarity on what is deemed “essential” medical treatment for travel purposes, and how long a person has to restrict their movements for when they return to Ireland after undergoing a medical procedure abroad.

Emma*, who lives in Dublin, began IVF treatment in Prague in the Czech Republic during the week. She said the process of undergoing fertility treatment is stressful enough without the added worry of travel restrictions and lack of clarity on what people should do.

She believes IVF is an essential journey, but said the government’s messaging on travel has been lacking.

“I’m on a few social media groups for people getting IVF and everyone seems really confused.

“We are allowed to travel abroad, but what is not clear and seems to be causing a lot of confusion for people, is the phase of restriction of movement.

“Do we still have to restrict our movements when returning from treatment? My reading of [the guidelines] would be that if I was an essential worker like a high-level engineer, I would not have to restrict movements coming into Ireland, so is it the same for us?”

Emma is currently taking two weeks of unpaid leave from work so she can self-isolate as a precaution.

TheJournal.ie asked Chief Medical Officer Dr Tony Holohan at Thursday’s Covid-19 briefing if IVF is deemed an essential medical reason to travel, and how long people should restrict their movements for when they return to Ireland.

He replied: “I would hope that anybody in that situation is under the care and direction of a consultant or clinician in this country who would be perfectly well able to understand not just the public health advice, but how it should apply to a particular individual in a particular clinical context.

“And if an individual is worried or concerned about what advice they should be following they should speak to their own consultants.”

Holohan said clinicians in Ireland will understand and interpret public health advice and “provide that to an individual who need individualised advice about their specific circumstances”.

“So anybody in this situation, who is seeking treatment outside of the country, I would hope that’s under the direction of a clinician in this country, to whom they should speak about how best to protect themselves and manage the risks that might arise for them.”

Many of the people who undergo fertility treatment abroad, including Emma, are not under the care of a consultant here.

TheJournal.ie sought further clarification from the Department of Health and the Department of Transport on the issue.

A DOH spokesperson said this: “Decisions as to what constitutes essential reasons for medical travel have to be judged on an individual clinical basis. If an individual is concerned about what advice they should be following, they should speak to their own consultants.”

The government’s latest travel advice can be read here.

PCR test

It was confirmed during the week that from midnight on 29 November, under new guidelines, travellers arriving into Ireland from so-called ‘red’ regions in the EU (most European countries) can move freely once they pass a PCR Covid-19 test five days following their arrival.

This provision will also be available to arrivals from orange regions who may not have availed of a pre-departure test. You can read more about the traffic light system here.

“Obviously, the new guidelines this week were welcome but they won’t apply to me this time. What Covid brings to everyone is uncertainty and that includes those of us doing IVF,” Emma said.

When she has to revisit Prague in a few months, Emma said she will try to get a PCR test when she returns but, even if it is negative, her employers have said she will likely be unable to work as she deals with the public every day so they don’t want to take that risk. She works as a contractor and will need to take more unpaid leave.

shutterstock_620722475 File photo Shutterstock / Africa Studio Shutterstock / Africa Studio / Africa Studio

Helen Browne, co-founder of the National Infertility Support and Information Group (NISIG), said other women are in the same position as Emma.

“It’s very very tough on people at the moment with Covid-19,” she told TheJournal.ie.

Browne said some people will want to keep the fact they are undergoing fertility treatment abroad private, but those who are upfront with their boss often have to take unpaid leave.

Some women will be able to use holiday leave, but this isn’t always an option. 

“It’s very difficult to get paid leave, the employer will probably say it has to be unpaid leave, rather than giving them paid leave,” Browne said.

“They have two weeks of wage or salary not given to them, an added expense on top of everything that they’re going through.”

Some women who undergo fertility treatment abroad attend a clinic that is linked to a clinic in Ireland, but many do not have a clinician based here.

“A lot of them go independently,” she said, so they can’t consult with a doctor here about what they should do in terms of restricting their movements.

Browne said people want more clarity on the right thing to do.

She said she’s aware of women having to stay abroad for longer than they typically would because of reduced flights.

“They now have to stay for about a week, rather than two or three days, because of the reduced flights. They’re actually having to pay more money for accommodation.

“Normally if they’re going abroad for a few days, their partner would go with them. But now because the partner can’t take a week off, most likely can’t take two weeks off, they can’t go with them. It’s really tough all round, they’re all on their own over there as well.”

Time is a factor 

It’s hard to get an accurate figure of how many people from Ireland travel abroad for fertility treatment each year but it’s believed to be in the hundreds.

Most people choose to go to the Czech Republic, Browne noted, but others go to countries such as Spain.

She said some people have chosen to delay their treatment but that this is not an option for everyone.

“Unfortunately, some people that go abroad for treatments are told that their ovarian reserve is dropping, and they feel now that they can go.

“By the time they get a chance to go, they’ll have no choice but to go for donor egg. Whereas they would like to have the opportunity of using their own eggs before they embark on donor eggs if they have to.

“If somebody said to me, I’m 39 now and by the time I get to go I’ll be 40, by the time I had my baby, if I’m lucky, I’ll be 41. That’s two years added on.”

The older a woman is when she becomes pregnant, the higher the risk in terms of complications, and many people need more than one round of IVF to become pregnant.

‘It’s a huge undertaking’

During IVF, mature eggs are collected from ovaries and fertilised by sperm in a lab. The fertilised egg or eggs are transferred into the uterus.

One full cycle of IVF takes about three weeks, but can take longer. It may take several rounds of IVF – sometimes over the course of years and costing tens of thousands of euro – for a person to become pregnant, if it’s successful.

“When you decide to do IVF at all it’s a huge undertaking, physically, emotionally and of course financially,” Emma told us.

She said she made the decision to undergo IVF before the Covid-19 pandemic and, over the course of the first lockdown, decided to go abroad for financial reasons.

“We decided to do IVF earlier this year but could not get over the cost of it in Ireland. While saving for a house it just seemed completely out of reach financially.”

Emma did some research online and joined a number of social media support groups, and found out that Prague “seemed to be a place that was affordable and also offered a good medical service”.

“We knew it would be a risk and would mean I would be travelling alone a lot of the time, but when your heart is set on starting a family, you’ll push and push until you find a way.”

Emma said the Irish government should fund fertility treatment so people like her don’t have to travel abroad.

“We are a modern country with an advanced healthcare system and so many more people going for IVF. It’s just prohibitive in its cost as it stands.”

Cancelled flights

Emma was in Prague for her first round of treatment during the week. She said the service was “great” but the overall experience was stressful.

“I’ve just had my first trip to Prague to a great clinic there, but the added layer of having to book flights, presuming they weren’t going to be cancelled, then constantly watching the government advice on international travel and Covid isolation periods was a huge source of stress.

“I’m back now but I have to take two weeks off work to isolate and that’s a tricky thing to do.”

Emma is concerned that if increased restrictions are introduced early next year, she may be unable to travel to Prague.

“This is what really worries me. It will be another few months before I go back for the next round of treatment and I’m really worried that international travel will be banned, we might be in a strict lockdown or the same thing could be happening in Prague.

“What if I have appointments and flights booked and I have to cancel? It’s a hugely stressful time as you have to follow strict hormone protocols for this kind of treatment, so Covid is a very unwelcome complication.”

Publicly-funded IVF in Ireland

Health Minister Stephen Donnelly spoke about plans for a publicly-funded IVF system in Ireland, as set out in the Programme for Government, in the Dáil earlier this month.

“This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary,” Donnelly said.

He noted that the plan will comprise three stages, starting in primary care (GPs) and extending into secondary care (regional fertility hubs) and then, where necessary, tertiary care (IVF and other advanced assisted human reproduction (AHR) treatments).

“Structured referral pathways will be put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate. It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years,” Donnelly said.

“The implementation of the model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology,” he added.

Browne believes it will take “quite a few years” for publicly funded fertility treatment to be available in Ireland – making it too late for many people.

She said a part-funded model is more likely – where investigations and blood tests may be paid for by the State.

“I personally cannot see the model in the UK, or in other countries where they will fund for two or three IVF cycles, here. I don’t know, maybe way down the line.”

Guidelines in the UK recommend that IVF is offered on the NHS to women under the age of 40 who have not conceived after two years of regular unprotected sex, or who have had 12 cycles of artificial insemination. These women should be offered three full cycles of IVF, the guidelines say.

In women aged 40–42 years, the guidelines say they should be offered one full cycle of IVF, once certain criteria is met.

Advice and support can be found on the NISIG’s website.

*Emma’s name has been changed to protect her identity.

With reporting by Michelle Hennessy

  • FUNDING FERTILITY – Our colleagues at Noteworthy want to examine why there has been a delay in publicly funding IVF in Ireland. See how you can support this project here.

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    Mute Silent Majority
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    Apr 29th 2014, 10:36 AM

    If he doesn’t get elected I’m sure there’s a role for him advertising doggy dentures.

    340
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    Mute Genius
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    Apr 29th 2014, 11:39 AM

    I thought i was the only one noticed that on the bus shelters,
    Driving home the other night i flashed the lightsat what i thought was a bike coming at me.

    107
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    Mute corkboi
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    Apr 29th 2014, 10:39 AM

    Brian Hayes deserves his face imprinted on a car door ,boi

    177
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    Mute Tony Hartigan
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    Apr 29th 2014, 1:40 PM

    Arrogant little b stard.

    66
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    Mute Shane O Malley
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    Apr 29th 2014, 2:50 PM

    i’d do time to wipe that cheesy slimy smirk of the runt of the fine gael’s litter face

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    Mute Inntalitarian
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    Apr 29th 2014, 10:49 AM

    Absolute muppet

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    Mute Dave Sherman
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    Apr 29th 2014, 1:28 PM

    Smarmy git. Cannot stand him.

    66
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    Mute Very fond of
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    Apr 29th 2014, 10:44 AM

    It’s 100% certain that Boylan and Childers will be elected. I’d be quite confident that Hayes will fail to get the remaining seat. FG/ Lab candidates will only get 2 or (maximum) 3 of the 11 available seats nationwide. Hayes will not be one of them. PS – that’s the first time I’ve seen Helen McEntee since she became a TD.

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    Mute PaulYates1929
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    Apr 29th 2014, 11:26 AM

    I wouldn’t be so confident that FG/Labour will get 2. I think Lab will get none but in reality Nessa only just took off her Labour knickers and hung it up beside her Green Party bra so….
    As for FG, They will get 2 in Ireland South on a good day, remember Wexford and Wicklow are two of the biggest FG areas in Ireland.
    They will get one in North-West-Midlands and I think Hayes if he gets his finger out will get his seat in the last round. Maybe it’s not what ppl want to hear but it’s the most likeliest situation. fF will get two and SF 3 seats. Marian Harkin will retain her seat most likely and Ronan Mullen’s will still be sitting in the Seanad. I hope Luke Ming doesn’t win as I don’t want him to leave the Dail

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    Mute Very fond of
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    Apr 29th 2014, 11:49 AM

    Paul – Wexford and Wicklow may well be strong FG counties but Ireland South is comprised of 10 counties. The majority of the electorate in the constituency live in Munster. No way will FG win 2 seats. Let’s not forget Brian Crowley is on 40% in the polls ( though I’ve no idea why! ) Kelly or Clune for sure but not both and Harris will get no votes in Munster. I’ll be hugely disappointed if Dublin elects Hayes. Your right about Labour – no seats for them.

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    Mute PaulYates1929
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    Apr 29th 2014, 12:05 PM

    I think Harris will loose but his transfers will push Clune and Kelly into a seat. Clune will do well in Cork city and is a woman and the scare mongering at the weekend over Kelly will make sure his supporters go out and vote . Almost a quarter of voters 23 per cent are undecided. I think it is still too hard to call and there will be an anti government protest vote but I think there will also be an anti SF aka people going out to vote because they don’t want SF doing well. Again this isn’t what people like to hear but it will happen to some extent.

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    Mute Jill Jones
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    Apr 29th 2014, 10:50 AM

    That mans face makes my morning commute insufferable. Every single pole, some only a few feet apart are littered with his mug and dodgy teeth. I struggle to keep my coffee down.

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    Mute Andrew Murphy
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    Apr 29th 2014, 10:57 AM

    Last week he was showing off a poster of his from 20years ago when he ran in a byelection aged 22. I think that might have been a real turn off for voters – people are sick of a candidates whose only life experience has been in politics. They want someone with a bit of actual experience!

    125
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    Mute Kerry Blake
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    Apr 29th 2014, 10:48 AM

    The only non looser in this election is Hayes if he gets elected he’s off on the euro gravy train if he doesn’t get elected he stays a junior minister in the local Leinster house gravy train. If he resigned as a minister and TD before running for Europe then I might have some respect for him.

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    Mute PaulYates1929
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    Apr 29th 2014, 11:28 AM

    Do you expect Luke Ming Flanagan to retire from his seat too before he ran for election ? Only asking now, don’t jump down my throat

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    Mute Norman Hunter
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    Apr 29th 2014, 11:42 AM

    Paul any sitting TD should as soon as they declare for Europe resign from the Dail no matter who they are.

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    Mute Kerry Blake
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    Apr 29th 2014, 12:07 PM

    Paul yes he should as should all resign when they declare.

    35
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    Mute Phillip Hogan
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    Apr 29th 2014, 10:45 AM

    Why is the journal even giving a platform to party politicians? We have had 100 years of bad decisions by bad politicians. It has been conclusively proven that all the established political parties do not care for the prosperity of Ireland. They want to keep is all perpetually poor just so we can be equal. Vote independent or don’t vote at all. It is our last chance to maintain a shred of national dignity. If this election does not make any progress in getting rid of the disease, I am going to don the balaclava and get rid of the disease myself, the old school way #wishful thinking

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    Mute VinHeffer89
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    Apr 29th 2014, 10:50 AM

    No, don’t encourage not voting. That keeps the status quo in place as the parties have a support base who will vote for them regardless. The established parties depend on people not voting as much as they depend on there own support bases.

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    Mute Phillip Hogan
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    Apr 29th 2014, 10:56 AM

    I would hate to see people not voting but I would really really hate to see people vote for any party. The most depressing thing is that there are still many many people who support these pseudo terrorist organisations, including the journal because they are constantly giving these lowlife politicians plenty of exposure, while denigrating independents. I would rather have a stupid independent than an evilesque party member

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    Mute VinHeffer89
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    Apr 29th 2014, 11:03 AM

    I agree with you. Party politics has been the ruination of the country. These people value the party over the country. However, it is part of their election strategy that some people will not vote. If suits them if people are duped into thinking that voting is pointless because “nothing ever changes”. That attitude plays directly into the hands of political parties because their supporters will give their votes and transfers to the party they support, therefore creating the illusion of a “majority”. I agree that people should wake up, realise the detrimental effect party politics has had on this country and vote Independent but I can’t endorse the idea of promoting abstinence from voting. It undercuts everything else you’ve said because you can be sure those who support the various established parties won’t forget to vote.

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    Mute Tony Hartigan
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    Apr 29th 2014, 1:43 PM

    Political dynasty should be wiped out.

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    Mute Norman Hunter
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    Apr 29th 2014, 10:47 AM

    So a free election guide along the same lines as the free fiscal treaty guide, or how to “scare the electorate into doing what you want guide”.Just hope FG are paying this time and don’t misappropriate tax payers money like they did last time.

    81
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    Mute Kerry Blake
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    Apr 29th 2014, 10:49 AM

    Some one should ask Hayes if they have returned that money yet?

    71
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    Mute Mike Clinton
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    Apr 29th 2014, 10:58 AM

    I was thinking that myself,where is the taxpayers money that was illegally used for the childrens referendum and the miney squandered on the senad referendum.

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    Mute sean de paore
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    Apr 29th 2014, 10:59 AM

    Is this the same Brian Hayes who stood on the platform with college students campaigning against college fees ?
    …and the same Brian Hayes who in government has seen said fees rise from 1500 to 1750 to 2000 excetera?
    I hope he doesn’t expect recent past or present student votes!

    78
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    Mute Inigo Montoya
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    Apr 29th 2014, 11:24 AM

    Students don’t vote… and when students are not students anymore they don’t really care about college fees… as opposed to everything else going on… sorry there Sean but you keep up the good fight.

    12
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    Mute Were Jammin
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    Apr 29th 2014, 10:57 AM

    I’ve a funny feeling that, for the next few weeks, we won’t be seeing hayes make his usual craven appearances on vincent browne explaining why the latest barrage of savage cuts and austerity measures inflicted on us by his government are ‘fair’

    77
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    Mute TOP CAT
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    Apr 29th 2014, 10:48 AM

    Brian Hayes,
    You can close the door on Europe..
    You ain’t going no where.

    71
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    Mute Daisy Chainsaw
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    Apr 29th 2014, 11:44 AM

    Brian has his job (and expenses) in Leinster House to fall back on if/when he fails. Sure, it’s not the EU gravy train, but a great slush fund nonetheless.

    He’ll lose nothing in the long run, unfortunately.

    50
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    Mute Joseph O'Regan
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    Apr 29th 2014, 10:55 AM

    We need to send a message to the political parasites that change is demanded by the people.

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    Mute Scorpionvenomm
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    Apr 29th 2014, 12:09 PM

    He’s a clown mr austerity the cheek of him saying that when people were suffering, karma is a bitch

    55
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    Mute Harry byrne
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    Apr 29th 2014, 11:12 AM

    What does “I have it all to do mean”..More furious public handshaking,extra lashings of baby photos,mountains more photo calls!?!?!..Would you ever go and jump off a cliff Hayes you useless Pr*ck!!

    55
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    Mute John Hartigan
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    Apr 29th 2014, 10:47 AM

    People ding starving and this shite going onn

    46
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    Mute Kate Ellen Egan
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    Apr 29th 2014, 11:39 AM

    Many swathes of areas in this country who have lifetime unemployed, even during the Celtic Tiger , never vote but their status quo is preserved

    13
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    Mute Barney r
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    Apr 29th 2014, 11:33 AM

    Is this a sponsored story? for parity can we expect a piece on all other candidates in the area. As they say all publicity is good publicity. Without opposition this only stands as propaganda

    34
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    Mute Dave cullen
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    Apr 29th 2014, 12:46 PM

    Hayes is on a par with shatter for arrogance toward the electorate!
    Theres a lot of voters in Dublin west he’s let down once he secured their vote.
    Hardly ever seen on the ground there after getting votes.
    Getting hayes onto Europes gravy train is kennys pet project.

    Hayes is the polar opposite of what a politician should be!
    His flight plans for Europe are decreasing by the day coming up to May23rd!

    31
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    Mute Brian Houlihan
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    Apr 29th 2014, 12:40 PM

    Can he legally stand? Or is it different since he’s a junior minister

    I seen this via Rabble

    “Cllr Brid Smith has called for Brian Hayes to resign: “In rule 5 of the Second Schedule of the European Parliamentary Election Act 1997, it states quite categorically that government ministers are not eligible to stand as candidates. If Brian Hayes looked at Form 8P2 concerning these regulation he will find on Section 8(e) the specific rule.

    I assume that the reason for this rule is that one cannot be involved in running both a serious election campaign and ongoing government business at the same time. Brian Hayes should therefore do the honourable thing and resign as a Minister of State.”

    24
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    Mute Aidan McGrath
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    Apr 29th 2014, 1:30 PM

    According to his own website he is Minister of State for Public Service Reform and the Office of Public Works.

    10
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    Mute Declan Cosgrave
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    Apr 29th 2014, 12:33 PM

    I’m very sure that he has his Fine Gael banner a typeface too small , is he trying to hide something per chance ???? , have a look at his poster next time and “guess” what party he belongs too…….

    20
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    Mute Declan Carr
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    Apr 29th 2014, 12:23 PM

    According to Brid Smith, Brian Hayes should resign as Minister. take a look at this: http://www.bridsmith.net/brid-smith-calls-on-brian-hayes-to-resign-as-minister/

    19
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    Mute Mr.Phil.Officer
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    Apr 29th 2014, 12:32 PM

    “I have it all to do” should say, I have had my chance.

    17
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    Mute Inigo Montoya
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    Apr 29th 2014, 11:22 AM

    ‘Savage Tits’

    11
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    Mute Shane O Malley
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    Apr 29th 2014, 2:46 PM

    soon the runt of the fine gael litter hayes shallbe no more

    9
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    Mute Doc
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    Apr 29th 2014, 9:31 PM

    Id say you’re some runt yourself, you have serious anger issues or is it just that you are associated with a certain party, seek help.

    1
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    Mute Shane O Malley
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    Apr 29th 2014, 11:11 PM

    whats up doc

    1
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    Mute Doc
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    Apr 29th 2014, 11:28 PM

    Very original, just about the capacity of your intellect runt.

    1
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    Mute Shane O Malley
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    Apr 30th 2014, 12:06 AM

    zzzzzzzzzzzzzzzzzzzzzzzzzzzz

    1
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    Mute Cowenwatch
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    Apr 30th 2014, 12:22 AM

    Coming from someone who said the other day that Hitler was a socialist, you’ve no right to use the word intellect in a sentence.

    1
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    Mute Shane O Malley
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    Apr 30th 2014, 12:21 PM

    cowenwatch,,bless the doc not an original bone in his body,,trots out the same mind numbing claptrat to anybody who disagrees with him,,but it appears to make him a happy little chappy so best leave him at it,

    2
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    Mute Cowenwatch
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    Apr 30th 2014, 12:54 PM

    Wasn’t it George Bernard Shaw who said ‘You shouldn’t wrestle with a pig – as you may find you’re both dirty and the pig is enjoying it’?

    2
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    Mute Doc
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    Apr 30th 2014, 10:53 PM

    Shane you’re an obnoxious runt and definitely not a member of mensa.

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    Mute Doc
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    Apr 30th 2014, 11:01 PM

    Cowenwatch, a journalist are you ? , what rag do you contribute to ?, if you bothered to peruse my response to your claptrap of recent you will fid that your lazy research shows you up to be the Neanderthal you are and the only pig commenting here is you oh and by the way you do a lot of wrestling and I bet you’re the sow LOL

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    Apr 29th 2014, 2:20 PM

    Sometimes in politics you get a good wallop .

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    Apr 29th 2014, 10:53 AM

    Bring it home Brian. We’re all behind you.

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    Apr 29th 2014, 12:18 PM

    Same way your behind and support Max Clifford Brendan?

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