Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

As Deputies, we are frequently contacted by patients or their families about the latest medicine for a specific illness that can transform the life of a patient. They are looking for approval under the drug reimbursement scheme. This is all part of the rapidly expanding area of healthcare known as personalised medicine. This means that medical care is based on the patients' own genes and specific disease. We know that genes are the information that tells cells in the body how to grow and develop. For example, many cancers affect or involve specific genes.

Through investment in health research, we can target treatments towards these genes in an approach known as precision medicine. This can be more effective at treating or managing the disease with far fewer side effects than other types of treatment leading to more successful and quicker recovery which is far better for the patient, reducing the overall long-term cost of the delivery of our healthcare.

This type of precision medicine is built on two key elements. The first is technology. Identifying specific genes and how they are expressed through an illness encompasses the whole field of genomics which plays an important role in the diagnosis and treatment of diseases, including cancers and rare diseases, enabling more efficient and accurate diagnosis and improving treatment selection. Genomics is driving precision medicine to improve clinical outcomes for individuals impacted by illnesses and their families. However, we can only use genetic information to develop tests for cancer and other diseases, and to prevent them, if we make the investment.

Although the Government made a commitment in 2020 to develop a national genomics and genetic medicine programme, this key area of healthcare in Ireland lacks clear funding and a structure to deliver this type of innovative technology for patients.

The second area is people. The days of the doctor examining the patient and then sitting at the end of the bed outlining a battery of broad treatments that will be administered to the patient in the hope of hitting the right one for that specific illness are, thankfully, confined to history. Instead, the doctor's treatment plan today is based on laboratory results from an ever-increasing and far more targeted range of tests that can facilitate the precision healthcare I just mentioned.

Just as technology has become more precise, however, so too has the importance of laboratory staff who are now more likely to be the decision makers when it comes to a person's treatment, care and, most importantly, recovery, than the doctor at the end of the bed. This is only set to increase in importance. Today, more than 80% of laboratory medical scientists are educated to master's level, with many having a second master's degree, PhD or another professional doctorate. Patients see first-hand how vital the role they play is and they have seen it very clearly over the last two days of work stoppages.

A carer who is in chronic pain contacted me last night. Her procedure was cancelled last January and then again on three subsequent occasions. She was given a further date this week. Again, it was cancelled because of the industrial action. In this particular instance, this carer has had to source an alternative carer on five separate occasions so far this year so that she could have that procedure. She told me last night that she understands the reason why the laboratory staff are taking the action they are taking. She supports them in having fairer pay and career development opportunities, but she also wanted to outline the impact this is having, not just on her, but on the person for whom she is providing care. As I said, she continues to suffer pain, inconvenience and stress and has done so over the last six months. The uncertainty this industrial action is bringing about is making it impossible for her to plan in advance.

There is huge frustration out there among medical scientists at the moment. After spending five years in college and having gained professional recognition for their qualification, upon graduation, medical scientists actually supervise and are responsible for medical laboratory aids, but bizarrely, their starting pay scale is lower than the people they are actually supervising. Once medical scientists are registered with CORU, the first reality check they receive is a pay cut. The second more depressing hit comes when they discover that if they decide to stay for any length of time in the public service, they will work alongside their biochemist colleagues who are performing the same duties, but they will not receive the same pay or career opportunities. Biochemist colleagues with the same qualifications but with less experience operate at consultant level whereas senior medical scientists operate at chief medical scientist level, which is the final level of progression for them. To add insult to injury, this pay parity anomaly was rectified 20 years ago and was then rescinded.

Medical scientist stepped up to the plate during the pandemic and the cyberattack, taking on additional duties and working additional hours, even though the workforce was seriously understaffed prior to Covid-19. The refusal by the HSE, Department of Health and Department of Public Expenditure and Reform to move on these issues has been a clear slap in the face to these particular staff members.

This situation whereby these staff are now leaving in droves is a missed opportunity to develop this profession and the whole area of medical science. It is a missed opportunity to bring about the type of precision healthcare we need in this country that ensures people are given the most appropriate treatment and discharged back into the community as quickly as possible or alternatively, that they are treated in their own home or community. The investment in the laboratory services and laboratory staff is key to achieving these objectives. It is imperative that we address as a matter of urgency the severe recruitment and retention problem we have in the service today.

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