John Gilroy (Labour)

The script has been proofed by one Dr. Susan O'Reilly of the NCCP over whose credentials Senator John Crown might stand. Before the Senator gets on his high horse and insults the Minister of State, Senator Colm Burke and me for being spoon-fed, the well thought out element of the Bill is not all on the one side. I suggest the Bill is not too well thought out at all. Section 3 seeks to provide for a statutory obligation to access certain drugs and section 5 contradicts that by allowing the Minister overrule it. What do we have? Do we have a statutory obligation or not? Perhaps the Bill is not thought out as well as its proponents say.

The text of any Bill must stand on its own. If the text allows ambiguity to creep in, the fault lies with the text of the Bill. The interpretation of any Act by the courts will be, in the first instance, interpreted by the text and, second, by the intention. We need to be very careful about the text of the Bill. That is the point I tried to make when the Leas-Chathaoirleach cut me off. I welcome the Bill as it draws public attention to a topic that is of very great importance and certainly its aims are such that it would be difficult to disagree with them. We know the number of deaths from cancer each year and the number of people affected by it. We agree that everything possible and practicable should be done to provide treatment and support for people thus affected. I commend the proposers of the Bill for making that point.

The aims of the Bill are commendable but the drafting raises concerns in some areas. It is difficult to argue that all possible steps should not be taken in support of cancer treatment but one immediately obvious concern is that, if passed, the Bill would place a potential cost on the State that may prevent the fair use of limited resources across the totality of the health service provision. If adopted it would charge the Minister to provide an almost unlimited access to treatment which, in the context of limited resources, within the health service may cause limits to be placed on sectors in other areas. This cannot by any measure be seen to be an equitable use of resources. When we have limited resources we must use them as efficiently and as fairly as possible and by definition these limited resources must be spread across all medical specialties. In a world with unlimited resources we could do that. Unfortunately, in this case it is not possible. What I am saying is that - Senator John Crown referred to it - a policy of unlimited funding for certain cancer drugs, however desirable, at the discretion of individual providers protects one sector of health programmes at an opportunity cost to other sectors. Everybody will agree this is not equitable. If we were to spend X plus €1 in one specialty that means, in our limited world, we must spend X minus €1 in another specialty.