James Reilly (Dublin North, Fine Gael)
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I move: "That the Bill be now read a Second Time."

I am pleased to have the opportunity to address the House on Second Stage of the Public Health (Sunbeds) Bill 2013. I see that we are joined in the Gallery by many young people who might be interested in this matter.

Skin cancer is the most common type of cancer in Ireland and is a particular problem for Irish people because of their fair skin. For most, the main source of exposure to ultraviolet radiation is the sun. However, many people are exposed to high doses of ultraviolet radiation through artificial sources. Sunbeds and sunlamps used for tanning purposes are the main source of deliberate exposure to artificial ultraviolet radiation. All forms of such radiation contribute to skin cancer. According to figures produced by the National Cancer Registry, there were over 10,000 cases of skin cancer in 2011. The most recent projections from the National Cancer Registry show that the incidence of cancer in Ireland is expected to double by 2040.

The most rapidly increasing cancers are expected to be those of the skin, both melanoma and non-melanoma, in both sexes. This is a significant threat to the future health and well-being of our people. It is a threat that must be faced now to avoid the harm that sunbed use causes and to reduce future costs to the health system.

There has been a growing body of evidence over recent years that the use of sunbeds, especially by children, should be restricted because of the associated increased risk of skin cancer and other health problems. Other recommendations by experts include ensuring adequate protective eyewear is provided to users, that users are informed of the health risks associated with the use of sunbeds, and that sunbed operators are prohibited from attributing health benefits to sunbed use.

The World Health Organization International Agency for Research on Cancer is a recognised leading expert scientific body charged with providing evidence-based science to underpin global cancer control policies. In 2009, the agency reclassified sunbed use from a group 2A carcinogen - one that is probably carcinogenic to humans - to a group 1 carcinogen - one that is carcinogenic to humans. We must be very clear that ultra violet light is a group 1 carcinogen which is carcinogenic to humans and which will cause cancer.

In 2009, my Department's chief medical officer conducted a review of the international literature on health effects associated with the use of ultra violet emitting tanning devices. He found that the medical evidence justifies a complete prohibition on the use of sunbeds by children up to 18 years of age, based on the significantly increased risks associated with exposure to ultra violet radiation in early years. In relation to specific subgroups of the adult population who are at increased risk and for whom ultra violet radiation constitutes a risk factor for skin cancer, the chief medical officer recommended that this could be dealt by way of regulation.

Healthy Ireland is the Government framework that sets out our vision to improve the health and well-being of the population. To realise this vision, Healthy Ireland will draw on existing policies such as the strategy for cancer control in Ireland, but it will also go further by instituting new arrangements to ensure more effective co-operation to achieve better outcomes for all in reducing the incidence of skin cancers. Achieving the goals set out in Healthy Ireland requirescomposite solutions. The banning of the use of sunbeds for children under 18 years of age and regulating their use for those over 18 is a very valuable initiative. Targeted interventions such as these will, in the long term, reap rewards and foster healthier living. Healthy Ireland will help to raise awareness on issues such as the dangers associated with sunbed use and will help promote healthy lifestyle choices by building on this legislation and by supporting and monitoring collaboration between areas such as primary care, hospitals, cancer screening and clinical programmes. Prevention is always better than cure and a lot less painful.

In drafting this Bill, my officials have consulted the Department of Jobs, Enterprise, and Innovation, which has responsibility for product safety matters relating to sunbeds and other types of tanning equipment. My Department has conducted a public consultation on the matter and has met interested parties, including the Environmental Health Association of Ireland, the HSE, the Irish Cancer Society, the National Standards Authority of Ireland, Quality and Qualifications Ireland, the National Consumer Agency, and the Sunbed Association of Ireland.

As required, my Department notified the draft public health (sunbeds) Bill to the European Commission under the EU transparency directive. During the three month notification period, the Commission had an opportunity to make observations on whether the draft Bill created new barriers to trade. The standstill period ended on 2 December 2013. The Commission did not make any observations which would extend the standstill period or require amendment of the Bill.

The Bill sets out the Government's proposals to protect children under 18 years of age from the risk of skin damage, in view of their increased risk of developing skin cancer; to regulate the use of sunbeds by those over 18 years of age so as to reduce their likelihood of, for example, developing skin cancer, premature ageing and damaging their eyes from exposure to ultra violet radiation; and to promote a greater public awareness about the risks of sunbed use across all age groups, with a long-term goal of reducing the incidence of skin cancers. As the Government's objective in this Bill is to protect young people, the Bill will make it an offence, therefore, to sell or hire a sunbed to a person aged under the age of 18 or to allow them to use a sunbed on a sunbed premises. The Bill prohibits unsupervised use of sunbeds in commercial premises. This will mean a de facto ban on self-service sunbeds, for example, coin-operated sunbeds, except where sunbed use is supervised.

The Bill provides for an exemption to allow the use of certain sources of artificial ultra violet radiation for medical treatment for specific skin conditions such as dermatitis and psoriasis in both children and adults. The exemption is limited to treatment involving phototherapy provided under the supervision or direction of a relevant registered medical practitioner such as a dermatologist. The treatment must be provided by a health care establishment. In line with the World Health Organization's recommendation that "protective eyewear must be worn during tanning exposures",this Bill sets out mandatory requirements in relation to protective eyewear. This is an important provision as the eyes are particularly vulnerable to damage from ultra violet radiation exposure. The Bill requires that protective eyewear comply with the relevant European harmonised standards and that it be sanitised after each use or disposed of in the case of single use eyewear. The Bill also sets out certain hygiene requirements, for example, that both sunbeds and premises are kept in a clean and hygienic condition.

Promotional practices, such as every tenth session free, rent a bed for four weeks and get one week free, or early bird offers, are commonplace which incentivise clients to use a higher number of sessions than they may have originally intended. The Bill prohibits such marketing practices in order to protect public health. It has been common for sunbed operators to claim certain health benefits for sunbed use, such as claims that indoor tanning is safer than outdoor tanning because it is controlled, when there is no evidence to support this claim, or that a tan acquired using a sunbed will offer good skin protection against sunburn prior to a sun holiday. In that case all one is doing is doubling one's exposure to ultra violet light, thereby doubling one's risk of skin cancer. Some operators claim an increase in the production of vitamin D resulting from sunbed use. However, the World Health Organization states that "incidental exposure to the sun, combined with normal dietary intake of vitamin D, provides adequate vitamin D for a healthy body throughout the year". Overall, the serious health risks associated with sunbed use significantly outweigh any claimed benefits. Therefore, the Bill prohibits the use of health claims other than those that may be prescribed by way of regulations.

This Bill is also aimed at raising awareness and helping sunbed users to make more informed choices. The key is to ensure anyone who decides to use a sunbed does so with full information about the associated risks. This is not a nanny State and we will not forbid or ban adults from using these devices but we want to ensure they are fully informed about the risks to which they are subjecting their health and their skin when making that choice. To this end, the Bill requires sunbed operators to display warning signs on sunbed premises and social media sites. The mandatory warning signs will inform the public of the health risks associated with sunbed use. In addition, to create an awareness of the dangers of sunbed use. including the risk of skin and eye cancer, people planning to use sunbeds should be provided with information on such risks. The operator of a sunbed business will be required to provide this information to a sunbed user in a specified form. The operator must also ensure the client has the opportunity to read and consider the information and has signed the form confirming that he or she has done so.

The Bill requires that those supervising the operation, sale or hire of sunbeds should be trained. Training will cover issues such as the risks of sunbed use, determination of skin types and exposure times, proper screening for potentially exposure limiting conditions, emergency procedures in case of overexposure to ultra violet radiation, and proper procedures.

In order to ensure the Bill affords the protection we intend, we must provide for an effective enforcement regime. To this end, and in order to be able to identify sunbed operators, the HSE will establish a list of sunbed businesses. The Bill will introduce a notification system whereby all sunbed operators, sellers and hirers will be required to notify the Health Service Executive or its successor. A notification fee will also be provided for.

To underpin the effective enforcement of this important public health legislation comprehensive powers are set out in the Bill. Authorised officers appointed by the HSE will have appropriate enforcement powers in order to carry out inspections and investigations to verify compliance with this legislation. A regime for fixed payment notices for specific offences, such as failure to display warning signs, will also be introduced. This sanction will provide environmental health officers with an additional tool to deal quickly and effectively with non-compliance with the legislation. It is important that the penalties for failure to comply with the legislation are both proportionate and sufficient to encourage compliance and in that regard, the Bill provides that on summary conviction, in the case of a first offence, the fine will be up to €4,000 - a class B fine - or imprisonment for up to six months, or both, and for second or subsequent offences, a fine of up to €5,000 - a class A fine - or imprisonment for up to 12 months, or both. The HSE may also publish a sunbed non-compliance list which will, in effect, name and shame offenders who make a payment to the HSE for a fixed payment notice, or have a fine or penalty imposed by the court.

This Government is committed to reforming the health service to provide a more proactive focus on promoting health and well-being and not only treating those who are unwell. This Bill represents an important step in that direction by ensuring that our children are protected from the harmful effects of sunbeds and by supporting adults to make better informed decisions about sunbeds. I reiterate that prevention is better than cure. Some 156 people pass away each year in this country from melanoma alone, 7,000 people are living with melanoma and there are many thousands who have other forms of skin cancer which require treatment which is sometimes quite painful and is a great expense on the State. I commend this Bill to the House as a real sign of our commitment collectively to prevention rather than paying lip-service to it.

Billy Kelleher (Cork North Central, Fianna Fail)
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We support this legislation and welcome its publication and this debate. The Minister alluded to the reasons this Bill is important. It is important for a number of reasons, primarily because it states a policy that Government and society in general are trying to bring about which is a preventative type of culture in our society not only in the area of melanoma and skin cancer but in the areas of obesity, lack of fitness and tackling underlying problems which people end up in hospital trying to cure rather than prevent. That is a philosophy that is beginning to ingrain itself in policy development. The next step is to ingrain it in the minds of people and this legislation in the context of skin cancer and melanoma will be a positive and proactive step in that regard.

There is no doubt that the statistics and data which have been collated from around the world, the research by the World Health Organisation and the experience of our neighbours in the UK indicate that excessive use of sunbeds is something which should be condemned and prohibited for those under 18 years of age. As this legislation will probably not be passed on time, although it could be, we will see the communion brigade where young children of eight years of age will be paraded into tanning shops to top-up their tans for what is, effectively, a religious ceremony in our schools. We should be conscious that we have a lot of work to do to try to establish in people's minds that some policies Government pursues are good for them in terms of adhering to the philosophy behind that policy. We can have a broader debate on the other issues at another time. However, we welcome and endorse this measure.

Looking at the whole concept of preventative medicine, it will only work if the public is well informed and if it understands the rationale behind it. The public should be made aware of it not only in terms of scare tactics but through an educational process. That is very evident in the area of recycling where the educational aspect takes place in schools and children educate the adults. Children are now saying to their parents that smoking is bad for them and that recycling and water conservation are good for the planet. It is a two-way street. We should use not only the stick but we must educate people with genuine knowledge that what we are trying to do is positive for them and society at large. If we collate all the evidence, synopsise it and put it out in basic form, there is no logical reason a person should use a sunbed other than if recommended to do so by a dermatologist or another clinician. The idea of young people being herded into tanning shops over the coming months is quite obscene and bizarre. I do not want to stigmatise individuals who do so but it is something of which they should be conscious. They are playing roulette with their children's lives in terms of potentially contracting melanoma or skin cancer, damaging their eyes or causing some other health fall-out.

The Bill stems from a growing body of empirical evidence collated from around the world which suggests that sunbeds offer few benefits other than cosmetic ones to people. The Bill will prohibit operators of sunbed premises from allowing anyone under 18 years of age to use sunbeds. That is the key and most central issue in this Bill. Obviously, no Government wants to create a nanny state. We do not want to interfere in people's lives. People are educated, they grow up, become adults and make informed decisions but the key question is that if we expect adults to make informed decisions, one would think they would make an informed decision not to put their children on sunbeds in the first place but they still seem to do so. Therefore, we have to become a nanny state, to a certain extent, for those who cannot make an informed decision. We will bring forward legislation which will ensure adults cannot make that decision for a person under 18 years of age and the law will rightly prohibit it. The evidence in this regard is there for all to see.

The Irish Cancer Society's sunbed briefing document is quite clear and comprehensive in terms of its stated mission. It refers to people with type one skin and type two skin and fair skinned people are more susceptible to skin cancer and melanoma as a result of exposure to ultraviolet light. We have to trust that if we educate and inform adults, they might begin to understand that sunbeds are not the best idea in the world. This Bill goes far enough in terms of trying to protect those we are obligated to protect who are under 18 years of age.

There were 158 deaths in 2011 from skin cancer which is an indication that we are not talking about a very unlikely event and that it is something which will not happen to people. This is clearly happening to people and it is affecting their lives on a daily basis. We will have to get over the thinking that it is an abstract statistic and that it will never happen. We will have to get over it not only in the context of sunbeds but in the context of people travelling abroad.

As a people, we simply have no concept of what it is like to contract and suffer from melanoma and other skin diseases as a result of ultraviolet exposure. In many countries in the Tropics, particularly First World countries, there is a proactive policy of ensuring children are protected from a young age, for example, in school. An example of this First World thinking when it comes to preventative medicine is the fact that hats are obligatory in parts of Australia and other areas. By contrast, many people in this country lather themselves up, fling themselves onto the sand in places like the Costa del Sol and bake themselves for hours on end. This happens week in, week out during the summer period every year.

The Bill might raise further awareness of the need to be conscious of skin protection and put on the right sunblocks and sun protections. People need to realise that when they go on holiday, it is not a competition to see who can come back the most tanned. We should try to ingrain in our people the idea that when they lie on the beach for a period of time, they should protect their skin by putting on the proper sunblock, rather than racing down to factor 4, factor 2 or factor 0 to get the ultimate tan. I would like to see the statistics with regard to the contracting of skin cancer and melanomas in this country. I would also like to see research showing how likely people are to contract such diseases from sunbed use or from ultraviolet exposure when abroad. I am quite sure it is available if only we could unearth it. It might focus people's minds on the dangers of excessive ultraviolet exposure from sunrays when they are abroad.

The details of this Bill, including the sanctions set out in it, need to be considered in the context of the policy background, the law as it currently stands and the statistics from the EU, Ireland and the World Health Organization. The Bill does what it says it does. It is about public health. It bans people from making sunbeds available to those under the age of 18. It ensures the operators of tanning shops will follow a code of conduct when deciding who can use their sunbeds. For example, they will have to inform sunbed users of the inherent dangers associated with such activity, such as the damage that may arise from excessive sunbed use. I think that is a very positive thing. Given that we are trying to discourage people from smoking by introducing plain cigarette packaging or changing the graphic design and detail of cigarette packets, perhaps the same point could be argued in the case of sunbeds, which have the potential to threaten people's lives by causing the development of melanoma or skin cancer. Rather than seeing sunbeds as glamorous machines that give one a fine tan for one's holidays, people should be conscious that they have the potential to threaten one's health and one's life. The statistics are there for everybody to see.

We can speak at length about issues we agree on. I would prefer to speak at length about the health service problems we disagree on so that we might be able to come up with solutions. As I have said, I welcome this initiative. World Cancer Day was last week. From time to time, I compliment the Minister on his efforts to make Ireland a tobacco-free country and his initiatives with regard to the EU directive. I emphasise, however, that we will face a major public health policy challenge in the foreseeable future in dealing with the increased prevalence of cancer as this country's population ages, its demographics evolve and, thankfully, people live longer. The prevalence of cancer will increase for many reasons and we will live with cancer for longer as individuals and as a society. We need to start putting the building blocks in place to ensure we have the structural and physical capacity in our hospitals to deal with that. We need to keep pace with technological advances and ensure we have the financial wherewithal to support and develop services in acute hospital settings. Various strata and tiers of medical infrastructure will be required. I do not know whether we are starting to focus on this key area as quickly as we should.

It is evident from the 2014 world cancer report, which was written by more than 250 leading scientists, that the number of cancer cases will increase by 75% over the next 20 years. This report was published by the International Agency for Research on Cancer, which is the specialist cancer agency of the World Health Organization. It points out that the prevalence of cancer across the world is growing at an alarming rate. It is obvious in that context that an aggressive effort to prevent cancer is needed. This is the ideal solution to many of these issues, but it is not practical in all cases, unfortunately, which is why we also have to deal with the other side of it as a Government, as a State and as a people. Indeed, this challenge must be confronted at European and global levels too. We must use our scarce resources to put a strategy in place to deal with the increased prevalence of cancer that people and society are going to have to live with for many years to come. I hope we do not bury our heads in the sand and let this issue drift to the point at which it becomes a crisis and we are incapable of catching up. As the Minister has often said, there was a time when people who contracted many forms of cancer were condemned. Now that those cancers are treatable, in many cases people make full recoveries and live for many more years. Forms of cancer that people were dying of 30 years ago are now eminently treatable and curable. I hope those advances will continue. A great deal of research and investment is taking place with the aim of finding solutions and treatments. That work is taking place in the whole area of preventative medicine as well. We still have to deal with the broader area.

While we support the Bill before the House, we would like the Minister to examine some areas that have been highlighted by the Irish Cancer Society. For example, the society has pointed out that the Bill does not prohibit people with type 1 and type 2 skin types - the fairest skin types - from using sunbeds. Such a prohibition has been provided for in Australia. While we should not copy everything the Australians do, we should note their aggressive promotion of public health policy. When one visits Australia, one can sense that preventative policies are proactively pursued there. One can see it there. It is everywhere. I appreciate that Australia has a different climate and is a more outdoor-oriented society. The Australian authorities encourage outdoor activities like walking. They encourage healthy living and exercise among all cohorts and age groups. When one goes to the beach there, one sees groups of people over the age of 65 doing stretches, exercises, gym work and all of that type of activity. Similarly, Australians are very aggressive when it comes to protecting their skin from ultraviolet exposure. They insist on children wearing hats in school and not being exposed to the sun for long periods. We do not need to mimic them, but we should take their advice on why they included the prohibition I have mentioned in their legislation. As certain skin types are prevalent in this country - a fair degree of our population has type 1 or type 2 skin - we should consider whether there is merit in adopting such an approach.

If we are not going to do it, at least the legislation should require sun-bed operators to inform people with those skin types of the higher propensity to contract skin cancers and melanomas - it may be in the legislation already.

Eye protection is critical. I once called into a tanning shop while canvassing and saw the goggles it supplied. We need an inspection regime to ensure they are not swimming goggles with a bit of red paint on them. We need to ensure proper goggles are provided to protect people's eyes.

If we pass legislation we need to ensure we provide the resources to enforce it. I do not know what agency will carry out inspections and oversee enforcement of this legislation. The vast majority of people who work in the sunbed industry are there to provide a service that is legal and used by many people. However, people need to be made aware it is a service that comes with many health risks. Forms people sign prior to using a sunbed need to make this clear. As opposed to appearing in the small print, these warnings need to be unambiguous and state in bold that using a sunbed represents a risk to the user's health. This needs to be to the fore so that people can make an informed and conscientious decision to remove their clothing and get into the sunbed or go home.

The purpose of the Bill is to protect people who up to now have been using sunbeds probably largely at the encouragement of parents or older siblings to tan up for a special event. If we did no more today, we should condemn that particular practice for the obvious reasons that we do not want to play with people's lives and health at such a young age. The research provides statistical evidence that the more a young person is exposed to ultraviolet rays the more likely he or she is to contract melanoma or skin cancer. For those reasons we should make it unlawful and explain why we are doing so. Equally we need to encourage our adult population to be conscious of their obligations and not to engage in excessive use of sunbeds.

Inspections are critical to ensure sunbed operators comply with the legislation. It is important this Bill is not just passed and left on the Statute Book. Very often such legislation can drift into people's subconsciousness and they do not take it too seriously. It is not until we have enforcement and a continual education programme around that enforcement that it takes effect and people become conscious of it and more importantly, supportive of it as they have done in other areas. With things such as drink-driving and cigarettes it took time for society to support and buy into a public health policy as they did with the road safety policy on drink-driving. We need to have education or at least awareness programmes on the matter.

There is evidence of sunbed use in advance of first Holy Communion ceremonies and television documentaries have been made on the matter. People going on holidays, particularly to Mediterranean and further south in the Tropics, also need to be conscious of such matters. We do it but we do so at a superficial level. We need to try to bolster it. Public health initiatives and educational programmes and policies encourage an overall interest in individuals' health and that of the people around them - it has a knock-on effect. Healthy living is not just about healthy eating; it is also about exercise, not using sunbeds excessively, not smoking and reducing alcohol consumption. By promoting a strong ethos of public health initiatives in our schools, and through educational programmes, awareness programmes and advertising programmes as well as through legislation and policy, people will buy into it. While it can be slow at times we ultimately get the reward, as we have seen in other areas of public health policy, particularly in the reduction of tobacco consumption.

We still have a long way to go to achieve the Minister's ambition of a tobacco-free Ireland by 2025. While that target will be difficult to achieve it is worth trying to do so. I do not believe anybody will blame the Minister, Deputy Reilly, if there are still one or two people in remote parts of Ireland having the odd cigarette.

James Reilly (Dublin North, Fine Gael)
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Tourists.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is certainly a worthy clarion call. Everybody should embrace the aim of driving tobacco consumption down to very low levels by the target date. It is also about other areas of public health.

The obesity issue must be addressed. I know the Minister is very conscious of it and is trying to introduce initiatives to promote healthy eating, etc., but there is an alarming growth in the number of very young people who are obese. One in five or one in six of our children under the age of eight is obese. The figures suggest this problem will get progressively worse as time goes on even with those initiatives.

Michael Kitt (Galway East, Fianna Fail)
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The Deputy is straying from the Bill.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank you for reminding me, a Leas-Cheann Comhairle. We are talking about public health which is referenced in the Title of the Bill.

When we pass legislation and subscribe to a policy there is a requirement to back it up on a continual basis to ensure that people adhere to it. Irish people are very slow in understanding that the sun can kill if they do not protect themselves from it.

I welcome the Bill and look forward to the debate on it. I do not want to take from the Bill; I published a Bill on the matter some time ago. This Bill is very similar, so I feel vindicated in having published it. I ask the Minister to look at skin types 1 and 2. If there are particular cohorts of people who are more vulnerable to developing melanoma and skin cancers, we should require the owners and operators of sunbeds make that very clear to people in advance of using sunbeds. I commend the Bill to the House.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I advise my Technical Group colleagues that I will not be using all my allocated time and I hope they will all get the opportunity to speak on this Bill before Leaders' Questions.

I personally and on behalf of Sinn Féin very much welcome this Bill as a vital protection of public health. Sunbeds cause cancer. It is as simple as that. Every effort needs to be made to minimise and eventually, through better public awareness and informed decision-making, to eliminate the use of sunbeds for tanning. As legislators, we have a duty to protect public health. In doing so, we have to strike a balance between what might be seen as coercion and the use of legislation to encourage modification of social behaviour.

We have done this quite successfully in relation to smoking, although much remains to be done in that regard. The ban on smoking in public premises and in workplaces has been a clear success in public health terms, but it would not have been possible without the years of widespread education of the public about the reality of lung cancer and the many other illnesses caused by smoking. That was a long battle fought against the massive resources of the tobacco industry and, as the Minister and I both know, that battle is far from over.

Smoking has both a social and a physical aspect. For some, there is a perceived social or peer pressure to smoke, although that has greatly diminished. Far more important is the physical addiction to tobacco that is so difficult for people to overcome. In contrast, the attraction of tanning with sunbeds is purely a product of social and cultural attitudes. It is about the body image held by many in our society. There is almost a compulsion for these sections of our population to have a permanent tan because of the widespread perception that a tan is necessary to appear attractive and even healthy. In contrast again to smoking, there is a widespread lack of awareness of the damage that sunbeds are doing. There is much work to be done to catch up on the public awareness that was essential in driving home the ban on smoking in the various settings that were introduced at the outset of its introduction. We have much to do in regard to sunbeds to bring people along the path to an equal or complementary realisation of the damage that sunbeds are doing.

A very interesting survey was carried out last year among 243 transition-year students at five County Sligo post-primary schools on their attitudes to skin cancer, sunbed use and tanning. The results were quite alarming. While there was a low incidence of actual use of sunbeds among these young people, there was a lack of awareness of the dangers. Of the teenagers surveyed, 77% thought tanned skin looks healthier and 73% believed it looks attractive. Of most concern is the belief among 73% of those surveyed that a sunbed tan provides a so-called safe base for a holiday tan, and the persistence of the myth among some that it is an address or, even more incredibly, a cure for acne. The clinical nurse specialist in dermatology who carried out the Sligo survey said that while the long-awaited ban on sunbeds for those under the age of 18, provided for in the Bill before us today, will be welcome, a nationwide sun awareness campaign is essential. I would certainly echo that call. I hope we will not only see this Bill progress but that the other essential messages and measures will also be adopted and employed over the period ahead.

Legislation, to be effective, must go hand in hand with public education and awareness. In this regard, I commend the work of the Irish Cancer Society which has done a great deal to expose the reality of what sunbeds mean for public health. The statistics are grim. Up to nine out of ten cases of skin cancer are caused by ultra violet radiation from the sun or from sunbeds. In 2009, the International Agency for Research on Cancer placed sunbeds in the highest category of cancer risk - as carcinogenic as tobacco and plutonium. I repeat that point - as carcinogenic as tobacco and plutonium. The most common cancer in this country is skin cancer. More than 9,000 people were diagnosed with skin cancer in this State in 2010, nearly 900 of them with melanoma. There were more than 150 deaths from skin cancer in 2011, the last year for which I was able to acquire those particular statistics. It is of great concern therefore that the incidence of melanoma is rising and the current rate is over 130% on that recorded in 1994.

The risk of developing cancer as a result of sunbed use is greater among the young. Despite this, the Irish Cancer Society researchers found that in 2010, 28,000 young people under the age of 25 used sunbeds in this State. What is very worrying is that many of them did so on a weekly basis. I was alarmed by that information.

Returning to the social attitudes which lead to sunbed use, 88% of those who use them are women and 20% are between the ages of 15 and 24. It is very clear that parents as well as children need to be educated about the dangers. That is a common task we must all face together. No responsible parents who are properly informed of the high risk of cancer to which they are exposing their children would allow them use sunbeds or expose them to that risk.

It is appropriate, therefore, that a special focus of this Bill is the protection of children and I commend that. I welcome the outright ban on the use of sunbeds by people under the age of 18. Welcome also is the new regulatory regime for a sector that has been unregulated up to this. I look forward to seeing these regulations put in place and implemented comprehensively, and I urge the Minister to ensure the necessary resources are in place to do so.

I am not certain of the outworking of section 14(1) of the Bill which enables the Minister to prescribe training leading to a qualification in the "safe use of sunbeds" which is recognised within the national framework of qualifications and-or equivalent qualification. The Minister might address that when replying to the debate on this Stage.

Apart from the exempted area of phototherapy, surely the whole thrust of this Bill is that there is no safe use of sunbeds. The message is for everyone, not just for those under the age of 18. It is not the position that on reaching one's 18th birthday the risk no longer exists - far from it. I accept that so long as sunbeds are permitted for tanning purposes, the providers must be properly qualified.

However, I would not like to see the impression given that the State is encouraging young people to train and receive qualification for something that, in time, we would like to see eliminated altogether. Perhaps this section can be revisited in the course of Committee Stage.

That raises the question as to whether a simple outright ban on sunbeds was considered. The Minister said "No" to such a step in his opening remarks this morning. I want to ask was it even considered in the preparation of this legislation and will the Minister give an answer to the House in his responding contribution at the close of Second Stage. In Australia, the states of Victoria, New South Wales, South Australia and Tasmania have banned sunbeds altogether, a fact I am sure the Minister is fully aware of. In the latest state to impose the ban, Victoria, almost 400 tanning beds operating in 118 solariums across that state will be shut down when the ban comes into effect in 2015. Again, I ask the Minister to expand on his reasons for not taking a similar course. Why follow Australia in regard to tobacco packaging but not on the use of tanning beds given that both have an indisputable link to cancers in human beings, something the Minister has acknowledged in regard to both threats to individual health and public health? I am anxious to tease this out with the Minister in order to get a clear sense of his reasons for making such a strong statement at the outset that no such step would be contemplated.

The Irish Cancer Society has called for the Bill to include a prohibition on people with type 1 and type 2 skin, the fairest skin types, from using sunbeds. I share that concern but I can see that a selective ban would be problematic given that all skin types are at risk. I emphasise that all skin types are at risk, so why ban only the higher risk types? These are important questions and issues we should address and tease out in the course of the passage of this legislation.

In conclusion, I welcome this Bill and I confirm that I and my colleagues in Sinn Féin will be giving it our wholehearted support. I emphasise again, as I have tried to impart to the Minister in the course of my contribution to Second Stage, that this legislation be accompanied by an effective public awareness campaign that we will sustain into whatever period of time is necessary in order to bring us to a point where more and more of our adult population are making an informed choice regarding the use of tanning beds.

Maureen O'Sullivan (Dublin Central, Independent)
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It is something of a paradox that we are talking about sunbeds and the need to have a suntan given the weather we are having. In another way, however, that perhaps explains people's need to have a year-round tanned complexion or a tan for special occasions.

Tanning is a business, and a very lucrative one, whether it is in regard to the sunbeds we are discussing, the various lotions that have come on the market or the need to go on holidays in sunny climates for that special occasion. It is interesting that at different stages in our history, we would not be having this debate because there were times when having a chalky white complexion was the look to have, and a ruddy or tanned complexion was considered to be for the labouring classes only. Times have changed.

This Bill has been underway for some time now and it is a good preventative measure with regard to cancer. Ba mhaith liom fáilte a chur roimh an mBille seo. Is mian liom tacaíocht a thabhairt don Bhille. I support what is in the Bill but I also want to acknowledge what the Irish Cancer Society has been saying, particularly its concerns that the Bill does not go far enough. At present, however, there is no regulation of sunbeds in Ireland, so the Bill is certainly progress on that front.

I want to acknowledge what the Bill will do. It ensures anyone under 18 cannot use a sunbed on official premises and prohibits the use of sunbeds on unsupervised premises. The sunbed operators will have to make users fully aware of the risks and warning signs must be in place in all sunbed operation establishments. Nonetheless, how the ban on the use of sunbeds on unsupervised premises will be enforced and monitored is highly problematic.

With regard to the risk warnings for those over 18 years of age, one of the points made by the Irish Cancer Society is that the Bill does not prohibit people with type 1 and type 2 skin, the fairer skin types, from using sunbeds, although such people cannot use them in Australia. As pointed out by the Irish Cancer Society, in Australia every client has to have a skin type assessment before using a solarium. Reference was made to the Fitzpatrick scale, which categorises the various skin types. It seems to be a straightforward skin type assessment, and I do not know where there could be a problem in applying it here.

With regard to warnings, we know that warning people of the risks associated with smoking is not having a major impact. Likewise, warning people of the risks associated with misuse and abuse of alcohol is not having a major impact. I sometimes wonder if it is making any impact when we see the amount of money that goes on the issues relating to the misuse of alcohol, whether that has to do with health or crime. We warn people about the dangers of getting involved with heroin, cocaine, snow blow and benzos, but they are still using them. We warn people about the sugar content in fizzy drinks but what we see are increasingly high levels of obesity. I hope putting warnings on sunbeds does not have a similar effect. It is a very problematic area, and, while we want it to have an effect, we have many examples where warnings are not working.

Skin cancer is the most common cancer in Ireland. There are deaths from skin cancer as well as increases in cases of melanoma. Some nine out of ten cases of skin cancer are caused by UV rays from the sun or from sunbeds, so reduced exposure to UV rays equals reducing the risk of developing skin cancer. The other fact I have alluded to is that people with fair skin or skin that burns easily - type 1 or type 2 skin - have an increased risk of developing cancer. Therefore, eliminating those people from being able to use these sunbeds would also be an improvement.

This does not mean we are living in a nanny state but that we are living in a caring state. In this context banning those under 18 years of age is also progress because those who start before the age of 30 have a 75% increased risk of malignant melanoma. Another alarming statistic from the Irish Cancer Society concerns the number of people under 25 who use sunbeds. What is really disturbing for me is the number of children, not just in Dublin but elsewhere too, whose parents seem to think using a sunbed before holy communion or confirmation is the way to go. I do not know what can be done to get the message home to such parents of the dangers involved.

Today, there are all sorts of tanning lotions, false tans and false sprays. Great improvements have been made from the days of the orange, "Oompa Loompa" look, so I cannot understand why there is not more of an emphasis on increasing the use of lotions and sprays instead of sunbeds. I would like to see sunbeds limited altogether, in the same way as with smoking. However, as with smoking, we just have to keep going.

Thomas Pringle (Donegal South West, Independent)
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I welcome the opportunity to contribute to the debate on the Bill. Like other speakers, I believe this Bill is a very welcome development. Sunbeds have been around for a long time and the damage they have caused has been known for probably just as long. One would wonder why it has taken so long to get to the stage of having a legislative base put forward in regard to controlling the use of sunbeds.

The Minister referred to the significant increases in the number of cases of skin cancer and melanoma since 1994. I wonder how much of this is actually contributed to by the use of sunbeds in the last 20 years; I would think quite a lot of it is. Therefore, while I welcome the Bill and believe we should have a legislative base for controlling the use of sunbeds, I wonder why it has taken so long to introduce legislation. This is something of which we should be aware because another product may come along in the next couple of years that will have a significant impact.

We should as a society be quicker to respond and put regulations in place to control the use these products.

As has been outlined by other speakers, the World Health Organization has classified sunbeds as a class one carcinogen along with things like plutonium and tobacco. One has to wonder about the discussion that took place about whether sunbeds are necessary and whether we should consider a complete ban on them because, obviously, the public health impact of that would be much more significant than trying to control the use of and access to sunbeds by people with vulnerable skin types or those of vulnerable age. Let us face it. The history of regulation and the enforcement of regulation in this country is abysmal. This legislation will only be as strong as the enforcement afterwards. Unfortunately, I do not hold out much hope for effective enforcement of the regulations introduced after this legislation is passed. We have a great habit in this country of passing legislation and putting regulations on the Statute Book. To all intents and purposes, it looks like we have a strong basis for it but when we look at the amount of enforcement that takes place and the difficulties the HSE faces with regard to staffing levels, one wonders whether any enforcement will take place.

The Irish Cancer Society has called for a ban on people with types I and II skin using sunbeds. I can understand why the Minister is refusing to do this because of equality legislation and the difficulty in having a selective ban. The fact that these two skin types are very susceptible to melanoma makes the question of the discussions and arguments about having an outright ban even more interesting. It would be interesting to hear what kind of discussion and debate around the issue of an outright ban took place in the Department when this legislation was devised. In response to a parliamentary question of mine, the Minister said the cohorts of the adult population at risk from ultraviolet radiation could best be dealt with by way of regulation rather than prohibition. I understand and accept that for the reasons I outlined.

Will regulation place an obligation on the operators of sunbeds to warn people in advance about their skin types and the fact that they are at increased risk so that they can make an informed decision when deciding to use a sunbed? The regulations must include that and ensure that people at risk of cancer from the use of sunbeds are identified by operators and that extra warnings are given to them.

The Bill introduces requirements in respect of the hiring of sunbeds and stipulates that they should not be hired out to under 18s. A few years ago, I noticed advertisements in connection with sunbeds being offered for hire. Such sunbeds could be brought to one's home and one could keep them for a week or two. Will regulations address the fact that although the people hiring those sunbeds may be over 18, children may have access to them? If someone over 18 hires a sunbed and allows it to be used by somebody in the prohibited category, will that be an enforceable breach of the law? That is something we need to see.

The main thing we need is a publicity campaign around the use of sunbeds. I know the intention of this legislation is to alter people's behaviour, including those at risk, and that is very welcome. However, the only way to achieve that is to get a wide-ranging publicity campaign going so that people are aware of the dangers, the new legislation and the behaviour that needs to change because, ultimately, that will point to the success or otherwise of this legislation. Hopefully, it will have the effect of reducing the levels of melanoma. I have concerns around the enforcement of the legislation and whether it will ultimately achieve its aims. This legislation is welcome and I wish it a swift passage through the House.

Jerry Buttimer (Cork South Central, Fine Gael)
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I commend the Minister for bringing this Bill before the House. Deputy Pringle and other speakers have issued a clarion call about the need for an awareness campaign surrounding this legislation and the impact that exposure to sunbeds can have. Arising from today, it is important that we send the message to parents in particular that children should not be exposed to tanning beds and that parents have a responsibility and duty to make sure that the obnoxious spectacle of young children having to use a tanning bed to look good before First Holy Communion, Confirmation or graduation does not continue. What happened to the old adage of "we are who we are" and self-acceptance? I hope that this debate can send a message that this type of behaviour is from an outdated era and should be changed.

As the Minister alluded to in his speech, we have a duty to protect the health of the nation. This Bill is the beginning of that with regard to the issue of skin cancer and melanoma. I commend the Irish Cancer Society which produced a very good piece of literature for Members of the Oireachtas in advance of this debate. Sometimes one hears that statistics are just that. However, one should put it in the context of information from the Irish Cancer Society that skin cancer is now the most common form of cancer in Ireland. In 2010, 9,450 people were diagnosed with skin cancer in Ireland. Of those people, 896 were diagnosed with melanoma, which is the most serious form of skin cancer. In 2011, there were 158 deaths from skin cancer in Ireland. If we put those figures in context, these lives could have been saved had there been an education and awareness campaign and had the people concerned been aware of the damage caused by ultraviolet light, be it from the rays of the sun or sunbeds. A total of nine out of ten cases of skin cancer are caused by exposure to ultraviolet rays, be they from the sun or sunbeds, and they can be prevented. That is the key point. We see the marketing of sun holidays and the marketing of the tanned look through models and celebrities. That all looks great in a glossy magazine where one has air brushing but it has an impact that must not be brushed aside. Cases of melanoma in this country increased by 66% in the past ten years. That is an extraordinary and spiralling increase that is linked to the issue of image and consciousness around how people look.

If we look at it in terms of public health, which this Minister is trying to espouse through Healthy Ireland, skin cancer has increased between 1997 and 2007 by 75%. That did not happen at the click of a switch. It happened because of a failure of public health officials to educate and make people aware and because in some cases, people did not take responsibility. I was struck by the figure from the Irish Cancer Society which reported that 140,000 people in Ireland use sunbeds on a regular basis. A total of 88% of those are women and 20% are between the ages of 15 and 24. I know we live in a country where we have had lots of rain but that figure should not be hidden but exposed because it is an extraordinary amount of people. I welcome this Bill because it is about reducing the exposure to ultraviolet rays and the incidence of skin cancer. That is, ultimately, the aim of this Bill.