Marc MacSharry (Fianna Fail)

I move: "That the Bill be now read a Second Time."

I welcome the Minister of State to the House and I thank her for yet again making herself available. She has given great commitment to this House over the last two years. I am proposing this Bill and it is co-sponsored by my friend and colleague, Senator John Crown, who is not short of expertise in this particular department. I proposed on the Order of Business that this Bill be accepted by the Government in the interests of a number of actors but primarily in the interests of patients. It is not political in nature as it is a non-adversarial Bill. I know that it has been the norm to vote down such Bills in the past, purely on political grounds. I appeal, in this instance, that it be seen for what it is, namely, the simplification of a process which heretofore has been complex and which has not put the patient in the centre of the debate on the provision of cancer drugs. It is a short Bill, but it is necessary in our view.

Recent controversies in this area have included decisions on drugs such as Ipilimumab, or IPI as it is known, and decisions taken by the National Centre for Pharmacoeconomics not to provide particular drugs, apparently for purely cost considerations . This Bill provides a process which puts the patient at the centre while still protecting the Government's necessary right to refuse the availability of a drug on particular grounds, such as the balance between patient outcomes and costs. The Bill would effectively create a scenario where the Government would have to opt out of the provision of a particular drug rather than the current scenario, which is effectively a situation where the Government must opt into the provision. Once approved by the European Medicines Agency, this Bill would ensure that the HSE would have to provide a drug for a patient. At the moment, a drug is approved by the EMA in the normal way, but nobody knows the process through which it then goes. It is certainly a very lengthy process. It is unclear who pays for it and how much it is going to cost. Individual hospitals may require a particular drug, based on the views of the oncologist and the haematologist. The pharmacist may wish to prescribe the drug, but the management of the hospital may not allow its purchase because the National Centre for Pharmacoeconomics has informed the management that it should not be available because the cost per year per life saved does not justify it.

What is the cost per year per life saved? What is the cost per year per life saved of having three junior Ministers, with all due respect to the Minister of State? What is the cost per year per life saved of Mr. Mark Costigan advising the Minister for Health? What is the cost per year per life saved in having gardeners prepare Leinster Lawn behind us? What is the cost per year per life saved of the provision of €3,000 per year to meat inspectors who must put up with the smell of meat to work in meat factories? The criteria used to determine whether a drug is specifically value for money or not are too crude. I am sure Senator Crown will go into more detail on this issue.