John Crown (Independent) | Oireachtas source

I have an urgent request for the Leader to bring to the attention of the Minister for Health something that has been bubbling under the radar for several weeks, the uneven access to cancer treatments for patients with private health insurance, depending on which company they are with. This causes spin-off problems for the public health service because patients who require particular treatment and have been paying a premium all their lives to their insurance companies in the expectation that legally approved treatments available in the public system and with other insurance companies would also be available to them are being denied. Their doctors, after a process of appeal to the company fails, have to discharge them from the private system and bring them to the public system where the treatment is given at taxpayers' expense.

I will be specific without mentioning any patients' names. I have one patient who is battling a serious problem with malignant melanoma. He has been deemed appropriate for the drug Ipilimumab which will be familiar to many in this House as a result of advocacy here and elsewhere and because of a recent high profile patient who bravely went on air and told the story of how he had received substantial benefit from the treatment. The insurance company in question is GloHealth and it has informed me that it will not cover its members for treatment with Ipilimumab. I regret to state that at this point the Garda's insurer, St. Paul's Garda Medical Aid Society, which I have found to have a good scheme and which gave its members great coverage has also been difficult in this regard, whereas VHI, Aviva and others have been paying for it. One could understand if there had been some failure of approval of this drug. However, it has been approved for routine use. It is an extraordinarily exciting drug. It gives huge benefit, albeit to a small number of patients, but they would otherwise inevitably have a fatal outcome.

The Minister for Health, Deputy James Reilly, courageously and correctly at a time of mounting financial pressure on him made the compassionate and humane decision that this treatment would be available to public patients, about which I was delighted. However, I do not know what pressure he can bring to bear in terms of insurance company approvals, but I will gladly say people have choices. Anybody opting to take out private health insurance should think long and hard before he or she signs up with GloHealth. This is the thin edge of the wedge. If this company is adopting a policy of putting itself outside the mainstream of what is considered acceptable practice, potential customers need to know this because it is very good a pointing to potential putative benefits of joining it.

I would like to make a bigger point on what is a nice sunny day. The highest rate of malignant melanoma of any group in the world - I am looking at my fair skinned red haired colleague - is among fair skinned red haired Irish people who move to live in sunny countries. The highest incidence is among Irish people living in Australia. God did not design us to live in the sunshine. We were evolutionarily adapted to live under grey misty skies. As soon as we started to travel, this tragedy occurred. The incidence of malignant melanoma in this country between 1998 and 2008 doubled from 400 to 800 cases. Thankfully, with early diagnosis - the disease has a bad reputation - most people will be cured. However, the incidence of fatal widespread secondary melanoma has also doubled and as these trends are likely to continue, we need to have access to treatments.

I would like to put another thought into the Leader's head to be conveyed to the Minister. The waiting lists to see dermatologists, both public and private, are unacceptably long owing to an unbelievable shortage of dermatologists. As a result, patients are presenting late and there is a higher chance they will have an incurable disease when they present. By saving some money in the short term by not having people appropriately employed, we are saving up a big problem, not only a humanitarian and health problem but also a financial one when these patients come back with more aggressive and more advanced disease.