HSE postpones breast cancer products policy after public criticism

New policy on post-mastectomy products was due to start on Saturday

The value of the vouchers are said by one provider to fall significantly short of the cost of new prostheses and bras.
The value of the vouchers are said by one provider to fall significantly short of the cost of new prostheses and bras.

The Health Service Executive has delayed the introduction of new rules for breast cancer patients, affecting their access to post-surgery products such as prostheses and bras, following public criticism of the policy.

In a statement on Friday evening, the HSE said the commencement date for the new policy “has been put back to August 2017 to allow for further communication with stakeholders”.

It follows concern expressed by breast cancer survivors that the new policy would significantly reduce their entitlements post-mastectomy but the HSE said there was no cost-cutting aspect to the changes.

Under a new national policy on post-mastectomy products, due to be introduced in all HSE regions this month, all breast cancer patients who have had a mastectomy will be entitled to one prosthesis per mastectomy and two bras following their surgery. They are also entitled to have their prosthesis changed every two years.

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Patients in public hospitals will be fitted for their prosthesis and bras in the hospitals, while patients in private hospitals will be issued with a form they have to present to their local HSE community healthcare organisation (CHO) office.

The CHO will issue the patient with a voucher worth €135.50 for a mastectomy, to cover one prosthesis at €68.50 and two bras at €33.50 each. For double mastectomies, the voucher will be valued at €204. Further mastectomy vouchers will be issued at two-yearly intervals.

Kate Conway, owner of Bravelle specialist lingerie in Limerick, said the value of the vouchers falls significantly short of the cost of new prostheses and bras.

The cost of a breast prosthesis ranges from €150-€200, she pointed out. In addition, the new rules do not allow for the provision of mastectomy swimwear, as currently provided for in some areas.

“This is a national policy that will affect every breast cancer survivor in the country. While I agree that the allowance needs to be standardised throughout the country, this new allowance seems very inadequate and unrealistic.”

In some HSE areas, patients’ entitlements to post-surgery products can be worth up to €500 a year, while in other areas, the entitlement is as low as €100, she said.

The HSE said the changes were being introduced because of issues relating to limited access and inequity in the provision of post-mastectomy products. “The new policies give greater equity to women who have undergone a mastectomy - products are now provided on an on-going basis to all women not just medical card holders as was the case previously.”

The voucher system would allow patients exercise choice over their preferred supplier, it added.

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.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.