Marie Sherlock (Dublin Central, Labour)

I welcome that we are having statements on men's health. I also acknowledge and pay tribute to Deputies Mark Ward and Seán Crowe for talking about their personal experiences. Leadership is important in terms of a lot of the things we are talking about, namely, breaking down the stigma that exists and helping people to overcome the inability to talk about their experiences. That inability is closely related to so many issues around to men's health. Often, there has been a failure to believe and recognise women's health conditions. For men, it has been about a huge failure to put themselves forward and the stigma and shame of seeking medical help, which we have to change. I acknowledge the Movember report that was published a number of weeks ago. It cast in very stark terms the premature deaths that occur, particularly in deprived areas, and the mental health issues that exist among men.

There are two issues I want to speak about. The first relates to mental health. It is absolutely shocking to think that 80% of those who take their lives in this country are men. We do not want to reduce them to a statistic. Each of those men had a family, a story and a community. That it is so heavily weighted towards men is really shocking. The Samaritans report, Out of sight, out of mind, from 2020 indicated that men in Ireland are three to four times more likely to die by suicide than women. While there is a crucial focus on young men, we know middle-aged men actually have the highest average suicide rate of any age group. Inequality, of course, and disadvantage also play a crucial part. Research from Scotland shows that men living in less well-off or more deprived areas are up to ten times more likely to die by suicide than those from more affluent areas. It is important to say that the suicide rate among Traveller men is over six times higher than the rate for the male population in general. Those are very stark figures. There is a need for real support. The Minister of State, Deputy Mary Butler, and I have spoken about this, and I welcome her efforts. Certainly, however, a huge amount more needs to be done in this space.

On cancer care, Deputy Cullinane referred to the difficulties in trying to understand how much extra funding is being allocated in respect of cancer care. It is a bit like the third secret of Fatima. I do not know whether we are going to find out or not, because we suspect that maybe there is not any additional funding for cancer care in the budget for next year, and that it will all be down to increased productivity. The reality is that cancer is the leading cause of premature death among men. I know from replies to parliamentary questions we have submitted on prostate cancer, which is, of course, the most significant cancer among men, that just under 39% of all patients get the treatment and care within the national cancer control programme timeframes. That is a serious concern. I have one constituent who got a heightened PSA result in summer 2024. It took until November to get an MRI. It was April by the time he got a biopsy and a diagnosis only happened in June. Surgery took place in September. I took a whole year for that care pathway to play out for him and for him to get the surgery he so badly needed. That is not acceptable.

The other critical point relates to access to drugs. There is a fundamental inequality regarding access to drugs, particularly oncology drugs, between the public and private sectors. I want to reference access to Pluvicto, which is an end-of-line therapy for metastasized prostate cancer. In April, 30 oncologists wrote a letter to the HSE to effectively plead with it to reverse its decision in respect of Pluvicto. This is a drug that is available publicly in Italy, Belgium, Switzerland, Austria, Czechia, Slovenia and Greece. In other words, it is widely available in many countries across Europe. It is approved by the European Medicines Agency, EMA. Not only is it a last line of therapy in the US, it is also seen as an appropriate therapy for earlier intervention. Yet, the HSE's clinical decision unit, CDU, has rejected the use of Pluvicto in the public system. The National Centre for Pharmacoeconomics made the submission for approval. Those who work at the centre are supposed to be the experts on cancer care. They submitted an application for approval, and it was rejected by the CDU. The HSE and the Department of Health need to issue a direction to ensure that this lifesaving drug is made freely available to men within the public system. It should not just be just be available in the private sector.

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