John McGahon (Fine Gael) | Oireachtas source

I thank the Minister of State for coming to the Seanad for this debate. I want to provide some context in anticipation of his response, which I have not seen yet, but I want to lay the groundwork for it.

The reason this issue was brought up in the Oireachtas and on "Liveline" over the past two days was the result of a letter that I received from Alison McCabe from Breastcare By Alison. She is from Dundalk in County Louth. She has been doing this job for between ten and 15 years, if not more. Alison was able to show us the potential cuts that were being proposed, not by the Minister but by the HSE, and reforms to this scheme by the HSE. I want to outline the context of the proposed cuts and what happened in the past 24 hours after the issue was raised.

The proposals came from the HSE. Currently, the approach is different throughout the country – in Meath, Louth, Donegal or Cork. There are different outcomes for different people based on their geographical area. In County Louth where I am from, currently a woman is entitled to two post-surgery bras, one prosthetic, or two if the woman has had bilateral surgery, one swimming prosthetic, two in the case of bilateral surgery, and one post-surgery swimsuit. Under the reforms proposed by the HSE, there would be a nationwide scheme but it would be reduced to €60 towards a post-surgery bra, which is not even sufficient to cover the fitting and supply of one post-surgery bra, and €200 towards prosthetics. That is the reform proposed by the HSE, and to make it a nationwide commitment.

There were three other proposals, which I will outline. One proposal in the reform is that ladies would receive their first fit following surgery in the acute hospital where the surgery took place. The reason why that is not a good idea is that it is an unrealistic aspiration, as breast care teams in hospitals are under extreme pressure and have enough important work to be doing in the hospital setting. This does not need to take place in a hospital setting.

Second, the changes aim to ensure service users who are post-mastectomy do not experience an increased financial burden in accessing these items. Again, that does not make sense because we are going to cut the funding they receive. That "we" is not the Government, but the HSE.

Third, the procedure does not include sports products, that is, for swimming or running. Women do not get that type of sportswear either. That was the proposal.

In 2017, the HSE made the same proposal and the then Minister for Health, Deputy Harris, said: "When I became aware of the proposed changes, I intervened and their introduction is now deferred." I welcome the response from the Minister last night in the Dáil. He said in a statement that he was aware of reformed procedures put in place by the HSE and is fully supportive of the provision of supports to all women regardless of medical card status. However, he understood the threshold of support provided under the new procedures may lead to some women being provided with less support than previously. The Minister said he had asked the HSE to amend the procedures to ensure "no woman, either currently availing of the scheme or accessing it in the future, is at any financial loss as a result of these changes". That is a great thing. I commend the Minister on saying that in the Dáil last night.

I hope the Minister of State can reiterate that today. The point is that this is an example of HSE bureaucracy. This is an example of reforms being made by the HSE without Government approval, ministerial approval, or the approval of politicians. It has caused a huge amount of widespread anxiety to breast cancer survivors, particularly in my county of Louth, and across the island of Ireland. I am glad the Minister has come out and clarified the matter and said that there will not be financial cuts to this scheme. That is a good thing. The HSE , the bureaucrats, and the people who designed this reform should never have gotten it to that stage in the first place.