Saturday 16 December 2017

Harris defers plan last-minute to ration vital post-op products for breast cancer survivors

  • Cancer survivors face further strain as HSE plans to cut entitlement to vital post-op products

  • Supply of bras and prostheses rationed for mastectomy patients

  • Health Minister defers planned changes, asks HSE for 'enhanced plan'

Health Minister Simon Harris Photo: Damien Eagers
Health Minister Simon Harris Photo: Damien Eagers
Health Minister Simon Harris Photo: Tom Burke
Eilish O'Regan

Eilish O'Regan

Health Minister Simon Harris has deferred at the last minute a plan to ration vital post-operation products for breast cancer survivors.

Thousands of breast cancer survivors who have had radical surgery could face added financial strain following the HSE decision to cut vital supports.

It follows the decision to ration the supply of post mastectomy bras and prostheses in areas where the scheme is working well in order to extend the service countrywide.

The unpopular changes were due to come into effect today, but last night the HSE was forced to postpone the introduction for a month.

Health Minister Simon Harris said in a statement released this morning; "Yesterday I heard of planned changes to supports for patients with breast cancer. This was the first I heard of these changes.

"When I became aware of the proposed changes, I intervened and their introduction is now deferred.

"Whilst I understand that the health service is working with a range of stakeholders, most importantly patients, to try to improve the supports throughout the country, this cannot take place before plans are put in place to ensure there is no hardship or reduction of supports for patients who are already receiving a particular level of service."

The minister said he has asked the HSE to get back to him with an "enhanced plan that doesn't adversely affect women who are already coping with cancer."

He continued; "I want to ensure that they are not  subjected to additional stress and worry about losing services.

"It is essential that every woman in this country in receipt of post-operative and cancer treatment supports continues to receive them. I want to be very clear that there cannot be any cuts in this area." 

Under the new scheme, women may only be provided with an allowance of €68.50 for one breast prosthesis every two years.

However, a prosthesis can cost between €110 and €200, two major suppliers warned last night.

Women will no longer be provided with surgical bras, other than those supplied when leaving the hospital.

The new scheme also means changes are also being made to the provision of wigs or hairpieces to patients. These will be provided on a once-off basis for cancer-related hair loss, and cancer-related alopecia. Patients will be provided with a maximum €440 voucher to purchase the wig or hairpiece.

The HSE attempted to defend the overhaul - saying the new scheme will give every woman the same service countrywide, and end the problem of some health areas having limited or no supports.

"The policies were introduced to ensure standard guidelines and equal and consistent access based on a patients' need and not their geographic location.

"The new policy now extends access on an ongoing basis to all women for post-mastectomy products - previously these products were only accessible to medical card holders," said a spokeswoman.

Dr Janice Walshe, a medical oncologist at St Vincent's Hospital Dublin, said: "While a diagnosis of breast cancer is difficult, the knowledge that a mastectomy is needed rather than a lumpectomy is doubly devastating.

"Patients will often suffer low self-esteem due to altered body image, so the importance for a woman to have a proper well-fitting good prosthesis cannot be overstated.

"Personally, I think it is inconceivable to think that women may not be wearing an essential garment due to inability to pay."

Dr David Fennelly, another oncologist in St Vincent's Hospital, said women who are recovering from breast cancer surgery are anxious to get back to a normal life and should have access to the best supports.

Marybeth Shiell, who runs the Everywoman service at Murray's pharmacy in Talbot Street, Dublin, said: "This seems to have blindsided everyone."

Kate Conway, who runs the Bravelle service in Ballyneety in Limerick, said the specialised bras can cost on average €50 to €60 each.

She called on Health Minister Simon Harris to intervene today and said it appeared the changes were "slipped in under the radar".

Around one in nine women will develop breast cancer. It is the most common malignant tumour diagnosed in Irish women, with 2,883 new cases each year on average.

This represents almost one-third of all major malignancies diagnosed in women.

Previously, cancer survivors in several parts of the country were entitled to two surgical bras.

If she had a medical card she may then be fitted and supplied with two surgical bras every year, and a new breast prosthesis every two years if required.

Under the new system, the HSE will issue the private patient with a voucher worth €135.50 post mastectomy. This will cover one prosthesis at €68.50 and two bras at €33.50 each. For double mastectomies, the voucher will be valued at €204 - further vouchers will be issued at two-yearly intervals.

'This is a pittance just to allow women to feel normal again'

"Come at me when I'm healthy and I'll fight you - but not when I'm sick when I can't," said Sandra O'Rourke-Glynn.

Diagnosed with breast cancer at the end of July 2015, the 48-year-old mother from Athy, Co Kildare, is still in the middle of chemotherapy and will shortly undergo a second mastectomy.

Afterwards, she hopes to undergo a breast reconstruction - but in the meantime says she "wouldn't go without" her prosthesis.

"Some people say it wouldn't worry them, but everybody is different and it's a must have piece of equipment for me."

When diagnosed, Ms O'Rourke-Glynn was told she was entitled to a wig up to the value of €750 and said there were members of her family who had never seen her without it.

Sandra O'Rourke-Glynn was diagnosed with breast cancer in 2015 Photo: Kyran O'Brien

"It's a time in your life when self-esteem is crucial and a good prosthesis and a decent wig really helps," she said.

Now women like Ms O'Rourke-Glynn are facing a cut of about 50pc in their entitlements - and she said this would be devastating for women who were just about managing financially. Women in her breast cancer support group were very upset, she said.

"There are so many women out there who won't be able to come up with the extra money.

"If you are entitled to a medical card, funds are tight," she pointed out.

She claimed that if it was a male issue, these cutbacks simply would not happen. "It just seems to be easier to attack women and women's causes," she said.

"This is a pittance to allow women to feel 'normal' enough to go to the shops so they feel people aren't staring at them."

By Nicola Anderson

Irish Independent

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