Plans to change postoperative rights for bad cancer patients caused outrage before being shelved earlier this year. The FOI documents seen by Jess Casey of Evening Echo reveal that the HSE was warned of the impact in 2014, three years before the change occurred.
More than three years ago, the Irish Cancer Society wrote to the HSE to urge the organization not to cut postsurgical fees for patients with bad cancer.
The organization was increasingly concerned about reports of HSE plans to "standardize patient access to mastectomy products throughout the country."
In 2014, the HSE was in the early stages of developing A plan to address what he described as "inconsistent" rights for bad cancer patients who had undergone mastectomies In June of this year, the HSE began to implement this new policy to address these differences.
However, this policy was delayed later due to considerable objection from both the public and the Minister of Health.
Recently published internal documents show that as early as May 2014, the Irish Cancer Society warned the HSE that changes in its policy about postoperative rights would be detrimental to patients.
Under the Freedom of Information Act, Evening Echo requested all documents related to the development of HSE of a new standardized policy for patients with bad cancer. Twenty-two documents covering three years were issued. In a letter dated May 2014, the Irish Cancer Society warned the HSE that any change in the current policy would be "to the detriment of cancer patients with medical cards."
"It is the understanding of the Irish Cancer Society that the HSE has actively sought to change the permanent policy regarding fasteners and prosthetics to the detriment of cancer patients with medical cards," the group wrote. "While the Irish Cancer Society welcomes any review of the HSE policies, we insist that this should not dilute the high standards of cancer care that have been established in Ireland.
" In this regard, we are concerned about reports that the HSE tried to introduce a new policy of a bra and a prosthesis every two years and would urge you, and the group members, not to pursue such an unfriendly cut. "
The letter continued:" After the introduction of HSE, and due to the lack of a uniform policy among health councils, organizations like society fought for a new right that covered all bad cancer patients.
"After the initial postoperative provision of two bras and one prosthesis, the right for women has been two bras per year and one prosthesis every two years, two for women who have undergone a double mastectomy, in addition to Swimwear and a swimming prosthesis Dignity is vital for a patient with bad cancer during both treatment and recovery.
"If such an informed cut were introduced, it would have a profound impact on the personal life of the patients. patients. "
Many patients come into contact with the Cancer Society & # 39; look for support and increasingly this support is financial & # 39; he continued.
" The first three months of 2014 saw an increase of 12 % in the number of applications to our financial aid scheme compared to 2013. This financial aid goes to cancer patients who are struggling to make ends meet. Some want to heat their home. Others want to make sure there is food on the table. We are concerned that such a cut would exert more pressure, financially and personally, on cancer patients and survivors. Bras and prosthetics for women who have had mastectomies are expensive and we believe that such a negative policy change is unnecessary. "
In response, the HSE wrote to the charity to inform it that a working group had been convened to work on the changes, which included representatives from the National Cancer Control Program, the Irish Association of Breast Cancer Nurses and the Society of Nursing of the Irish Cancer Society.
When the HSE began to extend its now defunct policy He said that patients in some areas around the country had limited or no services, while others had unlimited access.
"Policies were introduced to ensure uniform guidelines and equal and consistent access according to the needs of the patients. patients and not their geographic location. "
This new policy also now extended access to Continues to all women for post-mastectomy products, since previously these products were only accessible to holders of medical cards.
Currently, women in the South, including women in Cork, who undergo surgery for bad cancer, receive a prosthesis every two years through the HSE. They also receive two specialized postoperative bras each year.
Prosthesis costs may vary since the needs of each woman are different. According to the specialists, they average around € 165 but sometimes they can cost more than € 200. Specialized bras, designed to hold a prosthesis specifically designed for women's post-surgical needs, range from € 40 to more than € 70.
However, other women across the country do receive different benefits for women in Cork; some receive less, some receive more.
As of June 1 of this year, the policy had to be changed so that each woman at the national level received a coupon worth € 135 for an individual mastectomy, which is equivalent to € 68.50 the costs of a prosthesis and two bras They cost € 33.50 each.
However, these changes were met with a stir at the national level, as they effectively cut the rights for a large number of patients, including women in Cork. In July, Health Minister Simon Harris said he was "extraordinarily angry" at the way the situation was handled.
"I communicated in frank and frank terms to the HSE and the Director General, Patients who have gone through such difficult times do not need to have additional concerns," he said.
"Let me be very clear as Minister of Health and on behalf of the Government there will be no cuts in any patient with bad cancer."
The proposed policy changes were finally filed in August, and all plans to standardize care were returned to the drawing board.
It is understood that a new policy will be launched in the coming weeks.
After the HSE policy change in the summer, many patients thought the service had already been presented, according to Kate Hynes of Bellisima, a provider of mastectomy bras based on Victoria Cross Road.
"Every day, we still have one or two women who say 'Oh God, I thought you were gone' or 'I thought this had stopped and I did not know where to go & # 39 ; ".
Ms. Hynes recently traveled to Leinster House to meet with representatives from the Department of Health and HSE to make the call for the importance of the products she supplies to bad cancer survivors. She said: "I told them about the importance of the service we provide, why it is so important and the comments we receive from our clients and the impact that the withdrawal of the service would have on the daily lives of our clients."
Ms. Hynes also traveled with Fine Gael Senator Colm Burke, who arranged the meeting, and Anne Roche of Roche Cancer Care in Dublin.
She said: "The meeting was fine but I guess we will not know the result until the HSE reverses the changes they are going to make." The HSE said very clearly that it was not about reducing costs, but about clarity and equity in all over the country, but so far we do not know what that new policy will be.
"Recovery rates, survival rates for bad cancer are increasing because everyone is working to achieve it. It seems really unfair now that women live well, live longer and, however, could be penalized for their appearance. For some people that has a very, very damaging effect. "
Ms. Hynes said the changes could" eliminate all privacy "from the disease.
" Some women we've talked to tell us that if they did not have their prosthesis, they would never leave the house. We want the whole society to be an active member and that will not be the case for women if they feel that they look bad, that they are unbalanced.
"We are a first world country, we are looking to improve services, it is amazing that women live longer, it is fantastic, it is a testimony of the work that is being done, fighting against cancer, but it is not necessary to penalize them for The products are expensive because they are medical devices, it's not like an ordinary item that can go to any store and buy in. You need specialist installers, these are medical devices, it's like asking someone to pay for a false tip or a fake eye "