Use of debt collectors for cancer patient hospital fees ‘disgraceful’

Calls to abolish €80 inpatient charge for cancer patients in public hospitals

The practice of hiring debt collectors to collect hospital fees owed by cancer patients is “disgraceful”, Social Democrats co-leader Róisín Shortall has said.

Ms Shortall said it was “quite remarkable” how efficient the health service could be “when it’s owed money” and mentioned how one patient received 19 separate correspondences from a hospital and debt collection agency.

The Social Democrats put forward a motion in the Dáil on Wednesday calling for the €80 inpatient charge to be abolished for cancer patients and for debt collection agencies to no longer be used by public hospitals ahead of World Cancer Day on Friday. The motion also calls for the Government’s commitment to introduce caps on parking charges to be “immediately introduced”.

Cancer patients without a medical card or private health insurance must pay €80 for inpatient/day services, up to a maximum of €800 a year.


Where the charges are not paid within 47 days, the patient may be pursued by a debt collection agency under HSE policy.

“The practice of hiring debt collectors is especially disgraceful in my view,” Ms Shortall said.

“It is meant to intimidate patients who with everything else going on that their lives during treatment may just have not got around to paying or maybe they just don’t have the money or maybe they’re waiting for the outcome of their medical card application. Frankly, the reason doesn’t really matter, what matters is the absolute lack of sensitivity and understanding being shown to cancer patients.

“One cancer patient described the debt collectors’ relentless pursuit as bullying. She was told that if she didn’t pay up her name would be blacklisted for things like car loans or home loans, or even mobile phone contracts.”

The Dublin North-West TD said instead of winding down the “deplorable practice”, it appeared the HSE “has actually intensified its pursuit of patients” spending more than €4 million on debt collection agencies in the seven years up to 2020.

She added that despite being included in the programme for Government, hospital car park caps had yet to be introduced with cancer patients paying around €62 per week on parking fees.


Sinn Féin's health spokesman David Cullinane said no patient, especially those with a terminal cancer diagnosis, should be "hounded, threatened and terrified by debt collectors".

He said some of the letters sent by debt collectors “are nothing short of intimidation and put additional stress on patients who may already have financial difficulties and who are already dealing with the stress of cancer”.

Labour TD Duncan Smith said cancer patients face additional costs at a time when their average income drops by €1,500 a month, through inability to work or other reasons related to the illness.

“It’s a double whammy that really impacts people and their households at a time when they are at their most vulnerable,” he said.

People Before Profit TD Gino Kenny said he wasn’t sure that “anyone in the Government” could justify the costs for cancer patients.

The Dublin Mid-West TD said he had received recent contact from one of his constituents – a woman who was going through chemotherapy and had received a letter from a debt collector who wanted money owed “as soon as possible”.

“You can’t call yourself a civilised country if you’re chasing down people in the middle of chemotherapy for charges of the public services, it’s literally ludicrous,” he said.

The Government said it would not be putting forward a counter motion. Minister of State Anne Rabbitte said debt collection is managed at a local hospital level.

“The Minister [for Health] has been assured by the HSE that any such activity is managed in a socially responsible, ethical, efficient and cost efficient way,” she said.

Sarah Burns

Sarah Burns

Sarah Burns is a reporter for The Irish Times