Dr. Michael McCarthy:

This is a complex and multifaceted area, and the HSE has made great progress on this over the past several years. For example, since 2016, for solid organ cancers and medical oncology, about 125 new high-cost drug indications have been funded, and that is reflected in the cancer drug spend. In 2012, approximately €140 million was spent on cancer drugs and that rose to approximately €600 million in 2024. That is at list price; in actual cost probably 10% off that. That is all very positive and welcome and it was delivered by a lot of hard-working, well-intentioned people who showed great determination to get us this far, but, in terms of my own areas of practice, I treat gynaecological, head and neck and endocrine cancers. For example, it is my responsibility medically and legally to make sure I know what the cutting-edge treatment is for each cancer type. Just to list off some examples from the top of my head, there is toripalimab chemotherapy for advanced nasal-pharangeal cancer; cemiplimab for advanced basal cell skin cancer; cemiplimab for advanced cervical cancer; mirvetuximab for advanced ovarian cancer, which is coming in the next year to an earlier stage of the treatment; dostarilmab - the Deputy can tell me to stop if she wants - in second-line endometrial cancer. There are about 12 or 13 different drug treatments across my cancer groups that have a good evidence base for effectiveness, that are approved by the EMA, which gives an assurance that the trial was conducted in accordance with the regulations and that basic risk-benefit analysis-----