James Reilly (Dublin North, Fine Gael) | Oireachtas source

Skin cancer is the most common type of cancer in Ireland. It represents a major public health challenge in both the short and long terms. For most people, the main source of exposure to ultraviolet radiation is the sun. However, there is clear evidence that some people are exposed to high doses of ultraviolet radiation through artificial sources. Sunbeds and sunlamps used for tanning purposes are the main sources of deliberate exposure to artificial ultraviolet radiation. As we know, all forms of such radiation contribute to skin cancer. We cannot ignore the frightening figures and projections provided by the National Cancer Registry. I will repeat those figures for anyone who might think this proposed legislation is frivolous or indicative of a nanny state approach. There are over 850 new cases of melanoma in Ireland each year. Over 150 Irish people die each year from melanoma. There were over 7,000 people alive with this type of cancer in 2011.

Data from the HSE indicate that the cost of treating skin cancer ranges from €6,000 to €10,000 per patient, depending on the complexity of the disease. New high oncology drugs, such as ipilimumab, have become available recently. This treatment is effective in a number of cases but is extremely expensive. It costs between €50,000 and €80,000 to treat each patient with this drug. Between 60 and 80 patients present with such advanced melanomas each year. The incidence of cancer in Ireland is expected to double by 2040. The fastest growing number of cancers are expected to be skin cancers. These are not mere statistics. Behind each of these numbers, people are fighting painful and debilitating cancers. Many of them are winning that fight, but far too many of them are losing. The impact of these cancers on individuals and their families cannot be underestimated. The long-term treatment and its cost on individuals, families and the health system are significant. The sad reality is that we know this disease is totally avoidable. As I have already said, this is a true case of prevention being better than a cure that is sometimes very painful.

We must legislate now to put measures in place to protect our children and allow adults to make better informed choices. We must do all we can to discourage the use of sunbeds and encourage a healthier attitude to protecting ourselves and our children from ultraviolet radiation. Research and recommendations from the World Health Organization, the International Agency for Research on Cancer, the national cancer control programme and the chief medical officer have pointed to the abundant evidence in support of public health measures to regulate the use of sunbeds. Legislative action is required and justified to protect the public, particularly children and young people, from the risk of skin damage and the increased risk of developing skin cancer and to promote a greater public awareness across all age groups of the dangers of developing skin cancer, premature ageing and eye damage from exposure to ultraviolet radiation. I am convinced that this Bill will contribute to a reduction in the incidence of skin cancers in the long term. It is a comprehensive response to a serious public health issue. The Government's key objective in the Bill is to protect young people. Therefore, we propose to make it an offence to sell or hire a sunbed to a person under the age of 18, or to allow such a person to use a sunbed on a sunbed premises. I have taken note of the interventions in this House. I will ensure the measures aimed at the protection of children set out in this Bill will be commenced and implemented as a priority.

I wish to take this opportunity to call on parents to act responsibly when it comes to permitting or encouraging their children to use sunbeds. Parents may think that they are doing something positive in allowing their children to use a sunbed, but in fact they are risking their children's health. Parents must act responsibly to protect their children. There is no justifiable reason to allow the use of sunbeds by children under 18 years of age. Many Deputies have referred to the need to raise awareness about the health risks associated with sunbed use. We have taken this issue seriously in the Bill. To ensure adults who are considering the use of sunbeds fully understand the implications and risks associated with sunbed use, we will require sunbed businesses to display warning signs on the sunbed premises and on any social media used for advertising sunbeds. In addition, the operator of a sunbed business will be required to provide information to potential sunbed users on the dangers of sunbed use, including the risk of skin and eye cancer. This information will be set out in a specified form.

The operator will be required to ensure the client has the opportunity to read and consider the information, and has signed the form confirming he or she has done so before being allowed to use a sunbed.

Concerns have been raised during this debate regarding claims that sunbeds can in some way be good for people or can help with certain conditions such as acne. We know from all the scientific evidence that any claimed benefit for sunbed use is far outweighed by the risks. Where a patient is in need of phototherapy, the Bill provides a clear exemption for such therapy under the supervision of a relevant medical practitioner. Therefore, to avoid industry presenting confusing messages and making health claims for sunbed use, we will prohibit the use of health claims unless such claims are prescribed in regulations. We will also prohibit certain marketing practices aimed at incentivising people to use sunbeds more than they may have originally intended. There will also be a requirement that sunbed use on sunbed premises be supervised.

Through the Bill and the wider Healthy Ireland agenda, we will create awareness of the dangers of using sunbeds. We will promote healthy lifestyle choices among the public by building on this legislation and by supporting and monitoring collaboration between areas such as primary care, hospitals, cancer screening and clinical programmes.

I note the concerns raised by Deputies with regard to the quality of protective eyewear. The Bill requires that such eyewear should comply with the relevant harmonised EU standards.

A question was raised as to why we would require recognised training for those supervising sunbed use. We know that despite all the warnings and information campaigns around cancer risks, some people will continue to insist on using sunbeds. We need to ensure these people are fully aware of the risks, are properly supervised in the use of sunbeds, and that their use of sunbeds takes place in as hygienic an environment as possible. To this end we have, in line with many other jurisdictions, provided for the training of those who will supervise sunbed use.

I have been asked why we would not provide for a prohibition on sunbed use based on skin type. People with skin types 1 and 2 are melano-compromised and the World Health Organization recommends they do not use sunbeds. I strongly agree with this advice. The chief medical officer has suggested that those sections of the adult population at increased risk from ultraviolet radiation could be dealt with by way of regulation rather than prohibition. The HSE national cancer control programme has confirmed a similar viewpoint. The Department of Justice and Equality has advised that a prohibition based on skin type may be incompatible with equality legislation. Recognising the risks and legal complexities, we have taken the decision to deal with this issue by ensuring any adult wishing to use a sunbed is fully informed of the risks and is given appropriate advice to enable him or her to make informed choices.

I was also asked whether consideration was given to the provision of a complete ban on sunbeds in commercial premises. Having reviewed a number of options, it was considered that such a ban would be ineffective for the following reasons. It would simply move sunbed use from commercial premises, which will be regulated, underground to domestic premises where sunbed use would be much more difficult to supervise if it could be done at all. We could not, for example, be assured that warning signs would be in place or that the relevant information on health risks would be available to potential users of sunbeds as well as making it more difficult to protect children. Such an approach would be markedly different from the approach to similarly harmful items, for example, tobacco. It is possible that such a ban would be challenged on EU Internal Market and anti-competitive grounds. Industry might seek compensation through the courts for loss of livelihood. For these reasons it was decided that an outright ban on the use of sunbeds in commercial premises was not appropriate at this time.

I concur with the Deputies who highlighted the need for effective enforcement of this important legislation. I have no intention of passing the Bill for it merely to be left on the shelf. The environmental health service will be responsible for compliance building and enforcement. Environmental health officers, EHOs, have a proven track record in the enforcement of a broad range of environmental health legislation. They play a lead role in the enforcement of food safety and tobacco control legislation. As Deputies will be aware, over the past ten years since the introduction of the smoke-free legislation, EHOs have actively engaged in building compliance. When such efforts have been exhausted, the EHOs have been instrumental in initiating legal proceedings and defending the legislation in the courts. The significance of enforcement is reflected in the consistently high compliance rates of above 90% for smoke-free legislation.

Last November, in preparation for the introduction of this legislation, my Department established a national implementation group with the HSE and the Environmental Health Association of Ireland. This group will work with us in the development of comprehensive information and guidance to facilitate compliance by industry and to inform consumers of the new legislative requirements to protect their health and well-being.

I have listened to the concerns raised regarding the proposed level of penalties. I fully understand and agree with the sentiments expressed. This is why the proposed penalty rates are so significant while still being proportionate. The maximum rate for a first offence will be €4,000 rising to €5,000 for subsequent offences. It will also be possible to commit offenders to prison. These penalties are, as has been noted elsewhere, far higher than the penalties imposed for the sale of alcohol to minors. Given the medical evidence available to us and the worrying trends facing us, it is essential that we act now. I thank all Members of the House for their contributions and I look forward to the Bill being further considered on Committee Stage. I again thank the Deputies opposite for their support.

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