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Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Dr. O'Carroll has had to leave us to attend an appointment. I thank him for coming in today.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Okay. I thank our guests. I am going to bring Deputy Shortall back in for a short period.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Deputy, Ms Perry was trying to get in there.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Ms Perry might expand on the other points as well.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Deputy Shortall, we need to move on. I am sorry. I will try to bring you back in later.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Before I move on to Deputy Cathal Crowe, Ms Perry is saying that 70% of those with hepatitis C have a history of involvement with drugs. Are some of the other 30% relatives of drug users or is it a completely different cohort?

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Okay. Deputy Crowe is our next contributor. He is in two places - on our screens and present in the committee room. It is amazing. How does he do it?

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: I do not see any other members indicating.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: I have a few questions. It is important to get the message about this issue out to people and some of my questions will focus on that. The witnesses probably covered some of these points in their earlier responses. Ms Perry said in her opening statement that most people become infected with hepatitis C virus by sharing needles or other equipment used to prepare and inject drugs and went on...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: I am conscious that if one goes into community-based drug clinics, there are signs displayed throughout them advising people to wash their hands and to be very careful. There is always the chance of a person getting a cut and the virus being passed on in that way. On the fact that there may be no outward sign that people have the virus, most people would think someone who has contracted...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Can Mr. Keane expand on the testing of marginalised groups on their own grounds? That is referenced in the report. I understand how difficult that would be. There are streets workers going out trying to tackle crack cocaine addiction in my area. Would Mr. Keane envisage his group trying to get people into the system in that way? The importance of the needle exchange programme in tackling...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: If a person is in addiction, his or her health is not necessarily the priority in life, and that is the big challenge. It demonstrates the importance of on-the-ground experience and information coming from one's own peers or someone who has experienced that journey. Our guests made a point about the lack of information, minimal supports following a diagnosis, how to live with the disease...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Mr. Murphy referred to travel. If you are travelling to Dublin from the west, the first challenge is to get to the train station, after which you have to get to the hospital and so on. How long does the treatment in the hospital take? It probably involves queuing for half the day.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: I presume patients are tested for liver cancer and so on as part of that treatment.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: In any type of treatment, whether that involves travelling some distance to Dublin or whatever, work goes out the window. The person may not be able to attend work any day that week, for example. An economic impact arises, therefore, just as much as the other types of impact, from those local services not being available.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: It is true that many of the services are concentrated in Dublin, but there are a lot of people in addiction in Dublin and we have only a tiny idea of the number of people engaged in drug misuse in the region. It is an issue throughout Ireland now but intravenous drug use, in particular, remains significant in Dublin.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: It is a bit like a sexually transmitted disease, STD, whereby people do not talk about it in public. On the issue of the silent killer hepatitis amounting to a death sentence and so on, there are antiviral drugs and there is a cure, which is the main message. Our guests referred to the idea of telling people to self-test, the efficacy of that and what happens when someone finds out they...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: To return to the pilot test structure, which our guests reckon will not be in place until the first quarter of 2023, have they talked about rolling that out sooner? I accept there are governance and ethical issues, but they are structural issues that could be dealt with within a matter of weeks rather than a year. If there is any one message from this meeting, it is that we need to speed up...

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Moreover, the testing services need to move beyond Dublin, along with the governance structures. I suppose that is the other message arising from this meeting.

Joint Oireachtas Committee on Health: Elimination of Hepatitis C: Discussion (1 Jun 2022)

Seán Crowe: Regarding future research, will the Scottish model be examined? Is that seen as being the way forward for Ireland? It has been said it is a model that is clearly working in Scotland, where a similar cohort of people is affected. If we are talking about rewriting the model in Ireland, would the Scottish approach be the nearest one that is functional or would examples from further afield be...

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