Catherine Murphy (Kildare North, Social Democrats) | Oireachtas source

I thank all the Deputies for their contributions on and support for this motion. I also welcome the return of people to the Gallery who have a particular interest in this area. I acknowledge Erica Tierney. She is the patient advocate in my area and we chat regularly.

We purposely kept this motion narrow and focused because we think this is something that can be done. The Minister of State said she would have liked to have deviated from the script and I wish that she had.

I did not hear the opposition to debt collectors or immediacy regarding scrapping the inpatient charge. The Minister of State said that will come within the context of a review. There is no amendment opposing the motion, but neither am I hearing that the Government is going to do something in the immediate term, in particular regarding debt collectors and inpatient charges.

I wish the Minister of State, Deputy Butler, and her family well. I had a very similar experience on a couple of occasions in our household and I know what it is like when it comes. It is a bolt out of the blue because we all assume good health and this comes as a complete shock. When somebody gets a diagnosis, there is very often surgery, chemotherapy and radiotherapy. People think about things like their own survival. The last thing they think about is the financial implication, until they are forced to. The last thing people expect is a bill. I could not get over actually seeing such a bill. I am sure that is how others feel. I do not think people expect to see a debt collector at their door. It is inhumane and has to stop.

There is a reality facing cancer patients. When we talk about medical cards, we need to ask who is being impacted by what we are trying to do here. There are people who do not have health insurance and do not qualify for a medical card. I accept that there are fully discretionary medical cards, but they take quite a bit of time to get and are not always granted. We are discussing the group in the middle, which is very often looking at their household income and wondering what they can cut out, because of housing costs, the increase in the cost of living and all of that. Very often, health insurance is not an option for people in that group. The qualifying criteria for a medical card for a single person living alone is €184. That is below the minimum social welfare rate. The qualifying criteria for a medical card for a household with two adults and two children is €342. The qualifying criteria for medical cards involve very low levels of income.

Last year I received a response on the take from parking charges in hospitals. In University Hospital Galway, the take in 2019 was €1.4 million. The following year, the take was €630,000. The difference was that visitors were not allowed visit the hospital because of Covid. Those figures show these charges affect patients. In Waterford, the take went from €1.2 million in 2019 to €469,000 in 2020. Covid has given us that piece of data. This is not exclusive to cancer care, but it gives us a picture of the kind of money involved. I was told there are no parking charges in ten hospitals and charges can vary considerably depending on the hospitals. Some hospitals have introduced a cap, and I want to acknowledge that.

Cancer is very stressful and stress does not help health outcomes. We need to consider what it is like for a person facing that financial burden. When Sláintecare was introduced, it was expected this would be one of the things that would be dealt with in year one, but we are still not hearing when inpatient charges will be dispensed with. We want people to focus on their recovery when they get a diagnosis.

A study by the ESRI found that almost half of all cancer patients found their cancer prospects were negatively impacted by their work environment, with the highest negative impacts reported by women, younger workers, the self-employed and those in the public service, which is of concern. We need to examine what exactly that involves. The same study found that the financial impact of cancer was driving cancer patients back to the workforce long before they were ready, which is not good for healthcare outcomes.

A survey by the Marie Keating Foundation found that more than half of patients focus more on financial difficulties than their own treatment, recovery and well-being. I understand the conference in Dubai is about wellness and well-being. We would like to introduce a bit of that into the care of our cancer patients. I find the facts as odds with why the conference was prioritised in the way it was. I thank both Ministers of State for being here.

The St. Vincent de Paul told us it has received 1,400 requests for assistance since 2019 from people who are struggling financially with a cancer diagnosis. It told us it recently began supporting a one-parent family with three children, the second youngest of whom is being treated for cancer and is required to attend weekly appointments in Dublin. The parent had no childcare so all three children had to travel to hospital, costing about €90 in petrol, tolls, parking and specialist snacks for the child that is ill, before the family car broke down and the parent had to take out a loan. That is the kind of thing that completely throws a family. When people have to give up work because they are caring for a family member, we can see the kind of costs that are involved.

Our motion is not so wide that what is proposed is not achievable. It looks for a very deliberate and limited changes to ensure that people will not have debt collectors on their doorsteps and inpatient charges are dispensed with. I do not think people expect to see that kind of bill coming to the door, in addition to their diagnosis. I would also like to acknowledge the work done by the Irish Examinerin a series which described people's personal experiences. People understand things better when they hear about the personal experiences of others, but it should not come to that.

The past two years of the pandemic have been incredible, and we all know that. We know there will be late diagnoses and the number of people who are impacted by cancer will escalate rather than reduce. The last thing we want to do is have people miss care and appointments because the financial burden does not allow them to do that.

The €80 inpatient charge needs to go and parking charges, at the very minimum, need to be reduced. I accept that ownership is not straightforward, and the nature of our health service means the system is quite fragmented, there are voluntary hospitals which are not under the HSE and so on. If there is a will there is a way to deal with this and reduce the burden. Car parking charges are a significant burden on households and individuals. I would like to have heard something very focused from the Minister of State and for her to provide timelines. I did not hear that today. That aspect is very disappointing. We will follow up on this.

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