Dáil Éireann Debate, Tuesday - 23 October 2018
70. Deputy Eamon Scanlon asked the Minister for Health his views on the campaign to abolish inpatient charges for cancer patients who do not qualify for a medical card and do not have private health insurance; and if he will make a statement on the matter. [43269/18]
View answerI am asking this question on behalf of my colleague, Deputy Eamon Scanlon. It is to ask the Minister his views on the campaign to abolish inpatient charges for cancer patients, specifically cancer patients who do not qualify for a medical card and do not have private health insurance.
I thank Deputies Scanlon and Curran for the question. Significant progress has been made over a number of years and over the lifetime of successive Governments in dealing with cancer treatment, with significantly improving survival rates in our country. The National Cancer Strategy 2017-2026 aims to build on the progress already made, with improved cancer prevention, diagnostics, treatment and aftercare support. The Irish Cancer Society made a significant input into the drawing up of the strategy and plays a very positive role in supporting people affected by cancer, for which I thank it.
While I appreciate the sentiment behind the society's campaign on hospital charges, making exceptions to these charges on the basis of illness or treatment risks creating inequity within the system.
The statutory co-payment, which is capped at a level that is not large relative to the true cost of providing hospital services, represents an important contribution towards hospitals' operating costs. While the overall charges are subject to ongoing review, we all need to be honest with each other about the significant financial implications their overall abolition would have.
In budget 2019 the Government decided to prioritise the extension of the GP visit card income thresholds, the reduction in the drug payment scheme monthly threshold and the reduction in the prescription charges for those aged over 70 with a medical card. The Sláintecare implementation strategy commits to considering all existing charges in the context of the annual budgetary process and this will allow for priorities to be determined in reviewing and considering the scope for a reduction in charges.
I would rather see a situation where we reduce charges overall than a situation whereby we pick a reduction based on disease or condition. While a strong case can be made, as the Irish Cancer Society did, people with chronic obstructive pulmonary disease, COPD, cystic fibrosis and other conditions could equally make the case. We are on a road of reform with Sláintecare that is committed to reducing further inpatient charges and the fact the current charges are capped at a maximum of €800 in any period of 12 months is the roadmap to use. The Department will review eligibility and charges as part of our Sláintecare implementation and I will certainly consider it in this context.
I thank the Minister. Quite obviously a diagnosis of cancer for anyone is a very concerning issue. This particular campaign is quite specific in who it addresses. It addresses people who do not qualify for a medical card and do not have private health insurance. If people are relatively affluent they may well have private health insurance. It indicates that people are on a fairly restricted budget. Many cancer treatments are over a protracted period of time. Generally people are either in work less or not at all. They have a reduction in income and at the very time they have a reduction in income they have additional treatment charges. While the Minister rightly states he is trying to reduce charges and that the maximum inpatient charge in a year is €800, this is a significant amount of money at a time when people are experiencing a reduction in income. It is for a specific cohort of people, not those who are particularly affluent but those who are squeezed, who pay for everything and who get very little in return. The concern is that the charge the Minister speaks about as being a reduced charge is a really punitive charge for this group of people.
I accept there were a number of issues on which the Irish Cancer Society campaigned in advance of the budget. I recognise it welcomed some of the measures in the budget. It welcomed the fact we heard their call regarding a rise in the price of cigarettes, which was supported throughout the House. It also welcomed the extension of the HPV vaccine to boys and the reduction in medication costs, although it and I want to do more in this regard. I accept it also highlighted very much, as the Deputy has done very eloquently, the impact, albeit capped, that large costs can have on somebody at a very vulnerable moment in his or her life. We know the burdens of cancer, not just the medical and psychological burdens but also the financial burden. I recognise this. What I am trying to say is that in addressing this burden I want to try to do so in a way that is not disease specific but recognises the fact there has to be an equality of access, and there are many people with a wide range of disease and illness who find themselves going to our hospitals quite a lot. I would like to use the work we are doing through the Sláintecare implementation plan to look at how best we reduce those charges. I will certainly look at the Irish Cancer Society's submission in this context.
I thank the Minister for his response. I will not reiterate all of the points. There is the specific concern with regard to some cancers about the longevity of the treatment and that it is over a protracted period of time. I indicated quite clearly that for some people it means taking time out of work. They are on reduced or no income depending on what they have. They probably do not have critical illness insurance or private health insurance. At the very same time, they have medical expenses. It is not just the direct medical expenses but the incidentals, including, as I stated earlier, car parking charges. They mount up for those attending and who require ongoing regular treatment over an extended period. If they have private health insurance, are affluent or in work it is different but there is a cohort of people who require fairly intensive treatment over an extensive period and their ability to meet these charges is quite restricted.
Deputy Curran and I are not going to disagree on this. There is no doubt there are extra costs when somebody has an illness, particularly one that can last a sustained period of time, such as cancer. It is not just a cost to the person but also to their entire family. We all have to work to try to reduce that cost burden. I am committed to doing that. The Deputy referenced the issue of car parking charges and I heard him speak about these earlier.
The Deputy is correct to highlight this. As he is aware, I have asked for a review of all car-parking charges and hope to be in a position to update the House in that regard very shortly.
