Fiona O'Loughlin (Fianna Fail)
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Last week, I raised concerns related to HSE-funded post-mastectomy products in the House. I am really glad that the Minister, Deputy Donnelly, showed real leadership and intervened as he recognised that the threshold of support provided under those new procedures may lead to some women receiving less support than before. He asked the HSE to amend the procedures to ensure that no woman who is currently availing of the scheme or who might access it in the future would be at a financial loss as a result of the changes. It was very welcome to see him use his influence to further support women's healthcare here.

Somewhat similarly, I have been contacted by some local hair, scalp and wig specialists from my own area in south Kildare. The first lady contacted me to express her concern about changes in the terms of the provision of scalp and wig therapy funding through the HSE. She was concerned that proposed changes to the funding stream for hair therapy pieces would negatively affect those suffering from alopecia. I looked at this and no more than the post-mastectomy support, there seems to be a postcode lottery for what women would receive. For example, in Kildare, they would receive €750 worth of scalp therapy, wigs, etc. In Cork, it is €450 and in Kilkenny it is €550.Obviously, it is important that we standardise the amount right across the country. It should not be a postcode lottery, no more than with the post-mastectomy pieces.

I should add that this should be limited to those who have specific training in that, because, unfortunately, hair loss is not part of hairdresser training. It is important that there would be specialist training that would be recognised in relation to this.

From my conversations with Aileen, I am informed that a HSE funding stream was available for the provision and funding of hair, scalp and wig therapy for those suffering from alopecia as well as those suffering from hair loss because of cancer but that proposed changes that were due to come into effect on or after 4 March 2024 will remove this entitlement. I sought clarity from the HSE. They came back to me and stated that the introduction of a national standard with an increase in the allowance for the majority of areas in the country along with the ending of the inequities that previously existed is welcomed by service user support group, the Irish Cancer Society and healthcare professionals working in the area, and that eligibility is expanded, procedures are simplified and service users provided with great choice. That is excellent. I have no issue with that and we all would welcome it, but it does not clarify for me or for any of us the situation in terms of those with alopecia which is why I am raising this in the Chamber today.

Losing one's hair, whether as a result of cancer treatment or due to conditions such as alopecia, is very traumatic. It can have a hugely negative impact on people's self-confidence and esteem, especially for women. Our hair is inextricably linked to our sense of self and our identity and many women would choose not to leave their home than go out without an adequate wig or hairpiece, if they are suffering hair loss.

Alopecia is a medical condition and it is often the result of an autoimmune condition. I really would appreciate some clarity from the Minister of State.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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On behalf of the Minister for Health, I thank Senator O'Loughlin for raising the matter. I hope I can provide some clarity, although I am not sure if I can provide all the Senator seeks. I will try to come back to the Senator on anything that I cannot clarify.

The Health Service Executive provides an extensive range of aids and appliances to individuals living with different medical conditions to help them enjoy a greater quality of life than may otherwise be the case. Many of those products are provided under the community funded schemes.

At the outset, it is important that I say that the new proposed procedure in respect of hair loss was for cancer provision only and had no impact on non-cancer related alopecia patients.

As part of the HSE's improvement programme for the community funded schemes, a HSE national advisory group had examined the provision of an allowance for cancer treatment related hair loss. The HSE had recently published a new national procedure for the provision of an allowance for cancer treatment related hair loss. The HSE advises that the aim of that new procedure is to improve access and ensure patients with cancer treatment related hair loss who like wigs, hairpieces or other hair loss solutions receive a standardised allowance no matter where they live, precisely as the Senator has said.

The HSE has advised that awareness of a significant variation in the practice of funding hair loss allowances across the HSE means that a standardised approach should be implemented, as the Senator has already stated she agrees with.

The level of the allowance provided for in the proposed new standard operating procedure was set at €600. The procedure and the allowance level allocated were to be subject to periodic review.

Upon learning of the proposed changes, the Minister instructed the HSE to ensure that no patient, either currently availing of the scheme or accessing it in the future, would be at any financial loss as a result of the proposed changes. The HSE has since communicated to each CHO advising it to revert to the pre-existing level of contributions to patients in respect of hair loss until such time as the new procedures can be reviewed in terms of the proposed allowances to be provided in the interim until it is all dealt with and sorted out.

CHOs were also instructed to contact any member of the public who received an email or communication advising him or her of the new procedure to inform him or her that it has been withdrawn. This communication also reiterated that no person should be disadvantaged in any way in the intervening period.

The Minister for Health welcomes this clarification to all CHOs. The Minister also wants to ensure that the necessary supports are put in place so that every person has the same level of access to appropriate healthcare no matter where they live in Ireland.I am not sure if that answer addresses the alopecia question precisely, but it is important that Senator O'Loughlin has raised this issue as it perhaps provides some clarity in respect of confusion on the cancer-related piece.

Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State. In her reply, she stated it was important to note "that the new proposed procedure in respect of hair loss was for cancer provision only and had no impact on non-cancer related alopecia patients". I take from that that those suffering from alopecia will still be entitled to the same allowance as before. That is bringing clarity and I thank the Minister of State for that.

On the standardised allowance, we both agree that absolutely is where we want to be. I appreciate the Minister has instructed the HSE to press pause until there is further clarity on it. I honestly feel that, in terms of the sentence from the speech I have just reiterated, it is clear there may be proposed changes for cancer payment in terms of standardisation but that there will be no change for those suffering from alopecia. That is exactly what I want to hear and I thank the Minister of State for that.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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That is also my reading of it, but I am at 96% and I like to be at 102%. That is my gap but that is also my read of that reply. I would like the opportunity, however, to go back to the Department, to clarify for the Senator so that we can get to 102%.

Fiona O'Loughlin (Fianna Fail)
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I appreciate the efforts of the Minister of State.