Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I thank Deputy Shortall and the Social Democrats for bringing this excellent motion, which crystallises clearly the problems with the cost of cancer care. We have been speaking a great deal in this country in recent months about the cost of living. This motion speaks dramatically to the cost of trying to stay alive.

When people are diagnosed with cancer, their first thoughts should be about their treatment, the impact on themselves, their families, loved ones and friends and the journey ahead. However, for many one of the first thoughts is about whether they can afford the treatment.

The majority of people suffering from cancer are going through the public system. That is where these costs are being incurred, not through elective treatment options. The Irish Cancer Society's research is excellent and clear and paints a vivid picture of the challenges that these people and their families face.

I will speak about the costs in a moment because they have been well laid out by others. People who are facing into cancer are not incurring those costs with their pre-diagnosis incomes remaining static. According to a survey by the Irish Cancer Society, the average drop in income for cancer patients is €1,500 per month, which is €18,000 per year. Not only are they facing increased expenses, but also a dramatic decrease in their incomes due to an inability to work or other reasons related to cancer. Having to pay for vital treatment and meet other costs while their incomes are decimated is a double whammy for people at their most vulnerable time.

The debt collection situation has to change. The Government has to be unequivocal on this. I received a response to a parliamentary question that set out the amount spent on debt collectors year on year up to 2020. Starting at €439,000 in 2013, it increased to €532,000, €567,000 and then €585,000. In 2017, it was €603,000. It then decreased to €573,000 but was €687,000 in 2019. The spend in the year to date was €386,000 by September 2020, which is the latest figure I have, but in 2020 it was on course to being well over €500,000. Some €4.3 million of HSE money went to debt collectors. The HSE is invoking its national financial regulation NFR-25, which sets out that, if a patient has not paid an invoice within 40 days of it being issued, the patient will get a notice to refer to a debt collection agency within a week. Someone's debt is being sent to a debt collection agency six to seven weeks following an unpaid invoice relating to cancer treatment or another health treatment. We have dealt with constituents with unpaid utility bills, Sky Sports subscriptions and the like that have taken longer to get to debt collection stage. What is happening is immoral and has to stop.

As I stated the week before last when the Government did not oppose an Independents 4 Change motion, not opposing a motion or not tabling an amendment to it is not the same as supporting it or acting on any of its recommendations. The proposers of this motion would accept progress being made on even one, two or three of its requests, but what we got from the Minister of State was just a setting out of the status quo. That is not good enough. Tea and sympathy are not required; we are talking about real costs. The €80 inpatient charge has to end. The car parking charges have to end. Some hospitals have reduced their car parking charges or provide parking for free, but they are the exception to the rule. Hospitals are operating without a national policy on this matter. In 2018, the then Minister for Health, Deputy Harris, commissioned a report on parking charges. It was finalised in 2018 but has not yet been published. There is no excuse for that except an intransigence to tackle what many would consider to be reasonably low-hanging fruit in terms of reducing costs for people undergoing cancer care. Some of the car parks are private, which creates complications, but those are not insurmountable. The outsourcing of car park provision to private companies over the years is another example of the privatisation by creep of our health service. Once they are privatised, we say that we do not have responsibility for parking, but we should. It is vital. Deputy Cian O'Callaghan articulated the case of a wife visiting her husband while he was getting cancer treatment and incurring over €1,000 in car parking charges. We cannot stand over that. Nor can our health service.

The figures have been well laid out, including the inpatient charge and the additional home bills. There are additional home heating, electricity and telecom bills for people undergoing or recovering from therapies. We do not need to discuss current gas and electricity bills again. They are outrageous. The Opposition has made practical proposals to reduce them. When someone's income has been reduced by €1,500 per month on average and his or her costs are increasing across a range of areas just because he or she has been among the unlucky one in two people to be impacted by a cancer diagnosis, these are the issues that we need to tackle quickly if we are to have a health service of which we are proud.

The motion is wonderful and makes clear requests. Even if all of them cannot be delivered as soon as possible, the Government could at least make a contribution by achieving progress in respect of one or two of them. Unfortunately, we have not got that. We will get tea and sympathy from the Government rather than real change, and that is disappointing.

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