John McGahon (Fine Gael)
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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.

Thomas Byrne (Meath East, Fianna Fail)
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I just want to make one point first. I am not reading out the script that might have been provided to the Senator because it does not reflect the position of the Government and it certainly does not reflect the position of the Minister, Deputy Stephen Donnelly. I am getting that checked. I have been talking to the Minister. The position is that, first, we have championed women's healthcare from day one. The announcement that the HSE made was not sanctioned and is not and was not agreed by the Government. As soon as the Minister heard about this, he instructed the HSE to pause it. He has committed now to increase the supports and he says that no woman will be left worse off. He wants to emphasise that he, the Government, and Senators, have championed women's healthcare from day one of the Government. That is about as clear as I can put this issue. The decision has been reversed by the Minister, and no woman will be worse off.

John McGahon (Fine Gael)
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I really thank the Minister of State for that. I could not ask for a more unequivocal response from a Government Minister and from this Government of which I am hugely supportive. I have always been supportive of it.

The Minister of State alluded to the issue I raise. This occurred in 2017 and a Minister for Health had to come out and stop it. A HSE bureaucrat was trying to reform the system a Minister had to come out and publicly and make a statement. This has happened again in 2024 whereby a HSE official or bureaucrat has tried to reform a system and a Minister has had to come out and refute in and say it is not going to happen on his watch. That is great and important, but there is no way that these type of things should happen or get into the public domain without either ministerial, political or Government approval. As a result of that bureaucracy getting out, it has caused a huge amount of stress. I am so happy that this Government has stood very strong behind these cancer survivors. I am also happy that we have made it unequivocally clear in black and white. This is a good response from the Government. I thank the Minister of State.

Thomas Byrne (Meath East, Fianna Fail)
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I thank the Senator and others for raising this issue, including constituents. Some people in Louth were on to me as well about this particular issue. The script that has been provided here, by the HSE or whoever, does not reflect what the Minister has said. I speak with the authority of the Minister and I can state categorically that he has instructed the HSE to write to every woman it contacted about this proposal to tell them that it is not going ahead. While we will increase supports in parts of the country where the supports are lower, no area will see its current level of support decrease. That is direct from the Minister. I thank him for that.

I also thank everybody for raising this issue. People on the administrative side of the State who do a huge amount of good work need to be aware that these issues are of critical importance to all of us, including women. Last night when I spoke to the Tánaiste he reminded us that he was the Minister for Health who introduced the scheme. There is a huge political commitment to this. The women of Ireland and breast cancer survivors must be assured that we have their back and we will support this scheme. I again thank Senator McGahon for raising it.