Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I concur with Deputy Nolan in commending the Irish Cancer Society and the nurse line for all the wonderful work it does. It is greatly appreciated. We all have cancer care groups in our communities. I could talk about Gort and Ballinasloe and all the Deputies have them in their constituencies as well. That relief valve is important in our communities, especially for those of us who live in rural areas. We depend on those groups because they are a means of supporting people in the community and act as the access point to information and understanding in this regard. We talk about the local bus link and those people who volunteer to drive cars as well. We cannot have a motion like this and not acknowledge their existence and what those people do to support families.

As we have already heard, this Government has prioritised the delivery of the national cancer strategy and invested significantly in improved services and supports for cancer patients, including the provision of almost €100 million in new development funding in the last two years alone. This funding has enabled improvements such as the development and launch of Ireland’s first national skin cancer prevention plan; new referral pathways for patients with suspected cancer; the appointment of national clinical leads in psycho-oncology, cancer nursing and children, adolescents and young adults; the opening of a new radiation oncology facility in Cork and the construction of a new facility in Galway; further centralisation of cancer surgery in the eight designated centres; the repatriation of the CAR-T targeted immunotherapy services to Ireland; and increased use of previously-approved cancer drugs with increased patient numbers.

We are also continuing to develop survivorship services, including psycho-oncology services, to improve the quality of life of those living with and beyond cancer. Patients consistently identified the psychological impact of cancer as one of the most enduring challenges of a cancer diagnosis, which can occur at any point in the cancer experience. I do not want to labour the point about progress being made and I understand that this debate is focused on the financial challenges facing some people with cancer. It is important, however, that the House does not lose sight of the improvements in cancer care made in recent years, even as Deputies rightly seek to identify areas where we can improve further.

One of the areas of improvement identified by Deputies is hospital car parking charges. These charges are often highlighted as an additional burden on cancer patients and others who must attend hospitals frequently. That is why the programme for Government commits to introducing a cap on the maximum daily charge for car parking for patients and visitors to all public hospitals, where possible, as well as to the introduction of flexible passes for patients and their families. This subject arose when I met with the local patient advocate from the Irish Cancer Society. In my experience, it was a burden, as was even trying to find a space in the local hospital car park. Designated spaces should be provided to ensure ease of access, because we are talking about very frail people who need to move from the car to the oncology unit. Therefore, not only should parking charges be capped, but parking should also be designated and in a more appropriate setting. Spaces should not be at the back of the car park which can mean patients might have to walk 300 m when they do not have the strength to do so.

How this commitment can best be addressed is being considered, taking into account existing arrangements. While this process is ongoing, the HSE has advised that hospitals which currently charge car parking fees are cognisant of the financial implications of parking costs. Many hospitals have introduced maximum daily fixed parking charges and have reduced parking rates for long-term patients and visitors where the full rate would cause hardship. Having said that, it is only as good as it is communicated at local level. There must be better and clearer communication from local hospitals regarding how people can access those supports. That would be a help in itself. The use of debt collection services has also been referred to. Debt collection is managed at a local hospital level and the Minister has been assured by the HSE that any such activity is managed in a socially responsible, ethical, efficient and cost-efficient way.

This debate has highlighted the financial burden that long-term illnesses, such as cancer, can place on individuals and their families. It has also shown that help is available and we must ensure that people know how to access those supports, whether applying for a medical card or seeking other assistance. The Government is taking steps to address longstanding issues of affordability in access to healthcare. Budget 2022 again provided significant funding towards achieving universal health care and its three pillars of affordability, quality and accessibility, as envisaged by the programme for Government. Specific affordability measures being advanced under budget 2022 include the extension of GP care without charges to children aged six and seven; the abolition of inpatient charges for children aged 16 or less; dedicated funding of €30 million to ensure access for patients to new innovative medicines; a reduction in the drugs payment scheme, DPS, threshold to €100 per month from 1 January; and the provision of additional funding to enable progress to be made in addressing issues around access to community dental health services for medical card patients in 2022. The reduction in the DPS threshold and funding for innovative medicines may benefit cancer patients more directly, but the other measures will also ease the financial pressure on individuals with cancer and their families, depending on their circumstances. Moreover, in line with commitments made in the Department of Health’s statement of strategy, a review of the eligibility and charges system is planned. This reflects the fact that eligibility and some charges have been highlighted as a potential obstacle to patient access to healthcare.

Our current system successfully protects many people from financial hardship due to illness, but clearly there are gaps that we must address. The Minister for Health is committed to addressing those eligibility anomalies or barriers to ensure the health system cares for those in greatest need first. In line with the Sláintecare policy, however, the Minister believes that this aim is best achieved through a systemic and strategic approach to universal healthcare. It is generally acknowledged that Ireland has an unusually complex system of entitlements to publicly-financed health services. A focus on waiving fees or charges for individuals based on a particular medical condition would only increase that complexity, while potentially also creating issues of equity and, indeed, feasibility. The Government is instead committed to continuing to make progressive steps towards the provision of universal health care in the months and years ahead.

We have shown what is possible in our response to Covid-19 by providing universal access to testing, diagnosis and treatment for Covid-19 without charge and extending free teleconsultations for all Covid-related symptoms to the whole population. It is incumbent on us to learn from that experience and to develop services so that people with cancer, or indeed other illnesses, can access the right services based on need and not on the ability to pay. The Government will continue to invest in our health service and will work to improve protection and supports for those on lower incomes, while continuing to expand capacity and service provision. The implementation of the structural reforms we are progressing will ensure that all patients, including those with cancer, will get faster and more efficient treatment, regardless of means.

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