Marie Moloney (Labour)

Notwithstanding the veto afforded to the Minister under section 5, the section 3 provisions leave open the possibility that any patient could go to court on the basis that he or she has an entitlement to a particular drug regardless of the price. That is my major concern.

Senator Crown spoke about a drug which, because it cost €100,000, he could not justify prescribing in order to prolong a patient's life. I do not envy him the task of telling a person that he or she cannot receive a particular drug because it is too expensive. I was contacted some time ago by a person who had been refused treatment with a drug called Zytiga, produced by Johnson & Johnson. Even though it was approved for use in the United States last year and has also been approved for use in Europe, including Ireland, the Health Service Executive has refused to reimburse it. In other words, cancer patients can access it only if they pay out of their own pockets. The cost is so prohibitively high, however, that oncologists in this country are not even offering it to patients. This is particularly disturbing given that trials in the United States showed that it significantly slowed down the progression of bone metastasis and offered significant pain relief to thousands of patients. This is a drug that could potentially significantly extend the life expectancy of a category of cancer patients.

While focusing on access to cancer treatment, the Bill seems to ignore the issue of access to cancer services. I have called repeatedly in this House for the universal provision of medical cards for cancer patients. I spoke recently to a constituent who was refused a card despite being in active treatment. That is absolutely unacceptable. The Government has given a commitment to provide medical cards to all persons with long-term illnesses. The reality, however, is that some people in that cohort are quite wealthy and can well afford to access medical assistance. Our priority at this time should be to ensure that anybody undergoing cancer treatment is eligible for a medical card.

I would have liked to see an emphasis in the Bill on cancer services as well as treatment. We all realise that certain drugs are so costly that their provision under the public health system at this time is simply not possible. My main concern, however, is that the Bill contains provisions which might leave the State vulnerable to legal action.