John Crown (Independent)

I also welcome the news that Ms Louise Bayliss was reinstated. I speak with some personal authority on the issue of whistleblowing in the health service. This is a major problem at a time the service faces constraint. There will be problems and if we cannot depend on people who know what they are talking about, such as my old friend and colleague Dr. Gerry Burke who spoke out earlier, being protected when they point out deficiencies, there is a chance we will find that major omissions in care and departures from standards of care will not get into the public domain where they can be debated and, hopefully, corrected.

Parenthetically, on two occasions since I returned to the country in 1993, serious attempts were made by agencies of the State to silence me. In the first instance, it was suggested to the hospital where I worked in the 1990s that there might be a reconsideration of whether they would fund the rebuilding of the institution if it could not shut me up. On the second occasion, in the early part of his millennium, when I notified the statutory agency responsible for the oversight of ethical clinical trials about a departure from high standards, I found that I was suspended for one year as a clinical researcher as a reward for my whistleblowing. This is a problem which does not only affect people on temporary contracts such as Ms Bayliss but it can occur throughout the system.

While I am supportive of what the Minister of Health is trying to do, including his proposal for a new grade of consultant, and he is making a number of innovative changes which will enhance the quality of the health system, a number of specific problems arise. Eva Cassidy and Bob Marley, two singers whose haunting music will be recalled by many Members, both died in their 30s from a disease called malignant melanoma. Anyone who has seen the Cancer Research UK advertisement which has Eva Cassidy singing "Fields of Gold" without welling up with emotion is a cold person. It is one of the most moving evocations of the tragedy of the young dying from cancer I have seen.

Nothing worked particularly well to fight this disease over the years but a little revolution has taken place in its treatment. In particular, a new drug, Ipilimumab, has recently been shown not only to have a modest impact on prolonging the survival of patients with incurable disease but would also appear to offer to a small number of patients the prospect of long remission and possible cure. The drug is expensive, costing €120,000 per patient for one cycle of treatment. The reality is the incidence of malignant melanoma in Ireland increased from 400 to approximately 800 cases a year between 1998 and 2008 while the number of patients who died almost doubled. It is likely that both figures will increase reflecting the sun exposure Irish people have become more used to.