Recovered But Not Covered Campaign
The final item of business is a members' business debate on motion S3M-273, in the name of Brian Adam, on Macmillan Cancer Support's recovered but not covered campaign.
Motion debated,
That the Parliament condemns the extortionate premiums charged by many travel insurance firms to cancer patients or persons with a history of cancer treatment, which often lead to their travel insurance prices being considerably higher than journey costs; acknowledges that this problem will worsen with growing numbers of people diagnosed with cancer and living longer who want or need to travel; recognises its impact on patients and their families in Aberdeen North and elsewhere in Scotland; furthermore supports Macmillan Cancer Support's Recovered but not Covered campaign which seeks to make it easier for people affected by cancer to get fair travel insurance prices, and welcomes joint research between Macmillan and the Royal Bank of Scotland to investigate how cancer sufferers can obtain fairer travel insurance, but considers that these discriminatory and insensitive charges should be ended by other insurance companies.
Earlier this year, I had the opportunity to discuss a number of matters with Macmillan Cancer Support, which drew my attention to the particular problems in obtaining travel insurance that are faced by patients who have had or who might continue to have cancer. The current arrangements are quite discriminatory. However, that is the very nature of any insurance policy, and companies will inevitably make what they regard to be actuarially sensible commercial decisions. That is primarily a matter for the companies, but I believe that a range of issues associated with this matter should be resolved, and I hope that in her response to the debate the minister can reassure me that she will approach insurance companies through their joint body to address the concerns of cancer patients.
I will spell out the three principal problems that people who have cancer encounter in purchasing travel insurance: higher premiums; refusals of and exclusions from coverage; and the way in which companies deal with their potential customers.
Macmillan Cancer Support has identified that 39 per cent of people who are affected by cancer are quoted higher premiums and that some companies fail to distinguish between people who are undergoing active treatment and those who have been cancer free for several years. The cost of travel insurance is often higher than the cost of the trip. The problem is not exclusive to cancer patients—it affects many people with chronic health conditions. When the Minister for Public Health responds and, I hope, contacts the Association of British Insurers, she might wish to mention the wider context, as well as the particular context of cancer patients.
One in 17 people who are affected by cancer say that they have been refused travel insurance altogether. I do not know how other members deal with their insurance arrangements, but I tend to be a creature of habit. I would perhaps be better served if I shopped around every time I wish to purchase insurance coverage, but I often just go back to a company that provides a range of products for car insurance, house insurance or whatever. Rightly or wrongly, many folk simply go to their normal insurer. However, one in 17 people say that they have been refused, and the reason for the refusal is not always made clear to the customer. People are often not offered advice on where they might get insurance—they are just told, "No." Insurance companies are commercial organisations and are entitled to make decisions about how they conduct their business, but it is not necessarily in their interests to behave in that way. The companies are in a competitive environment, so it might be in their interest to be rather more accommodating in dealing with the issues that we are discussing.
Another of the vehicles by which insurance companies deal with applications for insurance is to say, "Yes, we are happy to insure you, except for your current condition," but that kind of arrangement is almost valueless for many people, so it is not the best approach. From time to time, the responses of the staff who deal with such inquiries are rather insensitive, which may be to do with their training. Macmillan Cancer Support has provided a quote from one of its clients, who states:
"I was offered insurance excluding cover for carcinoid tumour in my right lung, which I found amusing as I had already advised them that as my right lung has been completely removed it is highly unlikely that I would claim unless I make medical science by growing it back in again. As my cancer was very rare and not ‘normal' lung cancer I had extreme difficulty getting insurance people to understand the difference".
People who take part in Macmillan Cancer Support research activities report that type of insensitivity. The insurance companies would be best advised to consider closely how they deal with the issue.
I will close by giving an example from my constituency, for which I have permission to identify the individuals concerned. Norma Forbes and her husband, from Aberdeen, have had this type of problem. Mr Forbes has prostate cancer and is still undergoing treatment. Initially, the couple were covered by the insurance that they had already taken out, but when it ended they had terrible problems in trying to renew. They have had to accept cover that does not include Mr Forbes's cancer.
Many people want to be able to continue to travel. Of course the insurance companies have to deal with the risks, which are undoubtedly different, but we can significantly improve the situation. I commend the motion and Macmillan's campaign to the minister. I hope that she will be able to respond positively to my suggestion that she might approach the insurers.
As someone who was driven to get involved in politics by a belief that Scotland could be a fairer and better place, I think it appropriate that my first contribution to a debate in the chamber is to support a campaign to tackle a form of discrimination that still exists in our society. The Macmillan better deal campaign has successfully highlighted some of the grossly unjust financial hurdles facing people who have already been dealt one of life's biggest blows. It is simply unacceptable that people who are facing the stress and anxiety of being affected by cancer then find themselves also having to cope with the unexpected extra costs that seem to come hand in hand with a long-term health condition or illness.
I would like to pay tribute to Macmillan Cancer Support at the beginning of my speech for the work that it has undertaken to highlight the financial and emotional burden that is placed on cancer patients due to the cost of simply parking their car when visiting a hospital. Although we must of course encourage people to use public transport as much as possible, that is often not an option for cancer patients because of the treatments that they must undertake.
Brian Adam's motion highlights another financial cost—that of travel insurance. For people who are affected by cancer, the positive benefits of relaxing and recuperating on holiday should not come with extra baggage that none of us would relish—the exasperating task of speaking to countless insensitive insurance company call centres while desperately searching for someone who is sympathetic to their needs and can offer a deal that is not more expensive than their flights, if indeed they can offer a deal at all.
The stories of refused cover or downright silly sums being asked are unfortunately all too common. I will give members two examples from here in the Lothians. The first example is of a man in Edinburgh who was diagnosed with bowel cancer in 2006. He was quoted £2,000 for a short break in the sunshine. The second example is of a lady who had recovered from breast cancer after a mastectomy one year ago. She was advised by her doctor not only that was she fit to travel but that a holiday would be a good idea. She had hoped to visit a friend in Benidorm, and members can imagine her disappointment when she was refused cover entirely.
As those examples make clear, many people who have had cancer or other serious medical conditions are unsuccessful at wading their way through the murky waters of travel insurance to find a fair deal. Many end up scrapping their holiday plans altogether while others take the risk of going abroad uncovered. It is time to put an end to this inequitable treatment.
I commend Macmillan for the work that it is doing to make the system fairer, easier and less stressful. One example of that is Macmillan's useful web forum, which has been very helpful for people trying to access specialist insurance. It also offers sensitive and reasonably priced services. The forum has allowed many people to bypass the stress of going through several harrowing phone calls and horrifying quotes.
Macmillan's recovered but not covered campaign highlights one of the many ways in which people with cancer still face discrimination. Anti-discrimination legislation sends a signal of the kind of society that we want Scotland to be, but as the campaign shows, legislation is simply not enough. Changing society is about changing attitudes, and it is vital that employers, service providers and people from all walks of life receive that message loud and clear from the Parliament today. Discriminatory practices will continue to exist while we continue to put up with them. I commend the work of Macmillan Cancer Support in shining a light on this issue, and I thank Brian Adam for bringing it to the chamber today.
I, too, thank Brian Adam for securing the debate. I also thank Macmillan Cancer Support for its excellent work. The central point that we are here to discuss concerns travel insurance premiums, but the debate offers an opportunity to acknowledge that nowadays many people who are diagnosed with cancer can recover and live full and active lives.
As Brian Adam said, the higher premiums for travel insurance that cancer sufferers face also apply to people who have, or who have had, other conditions, such as asthma.
I hope that Cancer Research UK and other cancer charities will inform insurance companies of the new statistics on cancer recovery, as there seems to have been a lack of awareness of cancer as an illness. Macmillan Cancer Support believes that the approach that insurance companies have taken to cancer probably relates to the significantly lower survival rates of decades ago rather than to today's survival rates. I welcome Macmillan Cancer Support's proposal that we urge insurance companies to ensure that their staff receive cancer awareness training. However, such training can be beneficial only if those staff have full knowledge of cancer recovery statistics.
When I did my research for the debate, I was surprised by some of the personal stories that I read. For example, a woman who is now in her 40s was diagnosed with cancer at the age of 17 and finished her treatment five years later. She has never had a recurrence of the illness, but was understandably shocked when she was informed that her history of suffering from cancer back in the 1980s would almost double her travel insurance premium. Fortunately, she had worked as a Macmillan nurse and was able to inform the call centre operator that the fact that she had suffered from Hodgkin's lymphoma decades earlier did not represent a risk, with the result that her quotation was vastly reduced. Unfortunately, others are not as lucky or as well informed, so it is imperative that insurance companies are aware of all the facts.
There is no doubt that quotations of £3,500 to £4,000 for travel insurance are extortionate. It is unfortunate that people who have fought an often long and painful battle against cancer still face situations in which they are punished by insurance companies for recovering.
I am pleased to use the debate to highlight the fact that, according to our briefing from Macmillan Cancer Support, a number of patients have found the good old Post Office to be the best provider of reasonably priced travel insurance cover for cancer patients. Given the threat of closure that hangs over our post office network, I hope that many more people will get a quotation from their post office, not only for their benefit, but to help with the retention of the post office network.
I reiterate my earlier point that cancer sufferers often endure years of treatment to overcome a disease that can kill, so when they are given a new lease of life, no further barriers that restrict the enjoyment that they deserve for beating cancer should be put in front of them.
I congratulate Brian Adam on securing a debate on such an important issue, and congratulate on her excellent maiden speech and welcome to the chamber Shirley-Anne Somerville.
Recovered but not covered is one of many excellent campaigns that Macmillan Cancer Support runs. I am sure that we all look forward to taking part in Macmillan coffee mornings in the near future and I am glad that the organisation has raised an important issue, which Brian Adam has given us the opportunity to discuss.
Last night, a number of us were at a citizens advice service event to mark the launch of its new role in advising people with health problems, one aspect of which is the provision of financial advice. When someone has an illness, especially a serious one, the last thing that they want to have to worry about is financial matters. I have encountered that issue in a number of contexts. I was pleased to hear that there are now ways in which people who have serious illnesses can access benefits and advice more quickly from citizens advice bureaux.
Financial problems cause worry and can depress people who find themselves in the difficult circumstance of suffering from cancer. It must be particularly frustrating for people in that position to face such problems when they seek a holiday to help alleviate the daily stress and worries of their illness. As Brian Adam said when he spoke effectively about how some individuals have been affected, such treatment amounts to financial discrimination. As Shirley-Anne Somerville said, such discrimination is simply unacceptable.
Insurance companies must engage on the issue and I hope that they will be willing to do so. I hope, too, that all levels of government will support them to take action.
The joint research by Macmillan Cancer Support and the Royal Bank of Scotland is welcome. Let us hope that that ends with positive action and the right response from the insurance companies involved, which is to end the discrimination. I am sure that we wish to do all that we can to ensure that they engage properly in that process. I hope that we can give Macmillan all our support in making its campaign effective. The Royal Bank of Scotland is supporting the research and joining Macmillan in trying to progress the situation; that is welcome, but it is vital that the bank is not alone in doing that and that other companies, too, come to the table.
It is unacceptable that people in vulnerable circumstances are being put through the stress of having to meet higher insurance costs, or faced with the prospect of not being able to go on holiday. I hope that we can all support the campaign until its goal is achieved and the discrimination is ended.
I had not planned to speak in the debate, but I am doing so because the subject is important; I thank Brian Adam for bringing it to the chamber. I recognise the work that Macmillan Cancer Support does in supporting cancer sufferers.
When people are diagnosed with cancer, they often expect that certain things will be in place, such as ready access to information, advice and benefit systems. It can be a shock for people to find out that such things are often just not there. There are many examples of people struggling not only with the illness, but with finding appropriate information and support. In such cases, organisations such as Macmillan Cancer Support and Marie Curie Cancer Care can offer support to sufferers and their families. When my mother was diagnosed with cancer—she eventually died—I was surprised at how difficult it was to find out where to get support or basic information. Even though I was involved in community work, I did not know where to get the support, so what chance do other people have?
Apart from advice on benefits for cancer sufferers, it is important that advice is available on insurance in general, not just travel insurance. Constituents have come to me with issues around insurance for mortgages and loans, for example. People have found out that they have lost their insurance cover because they had an illness at some time in the past. They did not know until it was too late that the insurance company was taking away their insurance cover. I have fought a number of such cases for constituents.
It is important that the travel insurance issue is not only highlighted by Macmillan, but taken up by politicians and others, and raised in the Parliament and elsewhere. The last thing that someone needs when they are facing cancer or dying—although people can recover—is having to worry about money. They should be able to get the support and advice that they need. If they have taken out an insurance policy, they should have the assurance that it will be there for them when they need it and that they will have the same right to travel as others do.
One of my constituents was advised that everything was fine when she bought her travel insurance online. However, she took ill when she travelled to America and was faced with paying large bills when the insurer decided that they should not have insured her in the first place, because she had been much more ill than she said. It is unacceptable that people have to face such situations.
I thank Brian Adam for raising this important issue.
I have listened with great interest to the issues that have been raised during the debate. I congratulate Brian Adam on bringing the debate to the chamber and Shirley-Anne Somerville on her maiden speech.
It is hard to imagine what someone who has faced the undoubted difficulties and challenges of having cancer must feel like when they face yet another hurdle along the road to full rehabilitation. As Mary Scanlon said, survival rates have been improving. For example, breast cancer five-year survival is now at 80 per cent, bowel cancer survival is at more than 50 per cent and testicular cancer survival is at more than 90 per cent. More and more people are living longer with cancer, so the insurance issue that we are debating is a hurdle that more and more people will undoubtedly encounter.
It seems to me that this issue is not faced only by people who have cancer or who are recovering from it, nor is it unique to Scotland. The problem is surely a common feature for a great number of people, including those with diabetes and people who have had heart surgery, a stroke, or countless other diseases and conditions that may strike any one of us at any time, as Brian Adam said. The problem applies equally to other insurance, such as life insurance, mortgage protection, income protection and critical illness cover.
It is well known that insurance companies are likely to charge people who have a pre-existing condition that might increase their chance of becoming ill while on holiday increased premiums or offer an increased excess. The national health service cannot meet the costs of treatment abroad in such circumstances. The duty of NHS boards is to attend to the health needs of people who are resident in their areas in Scotland. There is no duty on boards to meet the medical costs of residents who become ill on holiday abroad. The onus is on the individual to take out suitable insurance. It follows that if the Government were to take the initiative to help people who have had cancer to obtain health insurance, a substantial body of people who have or have had other conditions might expect equal consideration.
The minister said that the NHS is not responsible for people who are taken ill abroad. Does that also apply to visitors who come to this country, or do such people receive free treatment from our NHS?
I will come on to reciprocal arrangements.
Financial services, including investment business, banking and deposit taking, collective investment schemes and insurance are reserved to Westminster, but it is surely in all our interests to avoid discrimination by seeking to work with the industry to make progress for the benefit of people in difficult circumstances.
Members might be aware that the United Kingdom has reciprocal health agreements with some countries. Except for countries in the European economic area and Switzerland, such agreements provide only for
"treatment the need for which arose during the visit",
which is generally taken to mean treatment for accidents and any newly diagnosed condition, and not the routine management of a long-standing condition. An unexpected exacerbation of a long-standing condition might or might not be deemed to fall within the agreements. That would depend on clinical judgment in the individual circumstances of the case.
Under the terms of the European treaty, a person who was visiting another member state of the European economic area and became ill would be entitled to any necessary health care on the same basis as a permanent resident of that member state. However, the state health care systems in EEA countries vary and there might be charges for services that the NHS provides free. Treatment for a pre-existing condition is not excluded from that arrangement. The only requirement is that a person invoking treaty rights must produce a European health insurance card that has been issued in the member state in which the person is resident. The EHIC replaced form E111 in January 2006. In the UK, the EHIC is issued free to residents on request and no details of medical history are sought.
Insurance companies are aware of the arrangements and should adjust travel insurance policy premiums to take account of them—companies usually warn the buyer that the policy will not cover them if they neglect to acquire an EHIC and are charged for treatment as a result. Travellers are therefore advised to take out private travel health insurance in addition to carrying an EHIC.
I am advised that some brokers specialise in higher-risk cases and might be prepared to help people who have had cancer or other pre-existing conditions.
As members said, the area is complex, so I welcome the efforts of Macmillan Cancer Support not only to raise awareness but to seek a practical way forward. I look forward to hearing more about the joint study between Macmillan and the Royal Bank of Scotland, which will investigate how cancer sufferers can obtain fairer travel insurance, especially as the findings could have a significant impact not only on people with cancer but on many other people who suffer from long-term conditions.
In response to Brian Adam's request, I will write on behalf of the Scottish Government to the Association of British Insurers, to highlight the issues that have been raised in the debate and to seek the ABI's views on what might be achieved through collaboration and partnership between the industry and Government. I hope that that will be of assistance to Macmillan's campaign and to Brian Adam. I thank all members who raised important issues during the debate.
Meeting closed at 17:34.