James Reilly (Dublin North, Fine Gael) | Oireachtas source

I am pleased to have the opportunity to address the House on Second Stage of the Public Health (Sunbeds) Bill 2013. I am sure Members will be aware of media coverage reports that skin cancer is the most common type of cancer in Ireland. It is a particular problem for Irish people because of our fair skin. The number of new cases of melanoma diagnosed in Ireland has been steadily increasing since the national cancer strategy began publishing data in 1994.

According to figures issued recently by the National Cancer Registry, there were more than 10,000 cases of skin cancer in Ireland in 2011. The most recent projections from the registry show that the incidence of cancer in Ireland is projected to double by 2040. Based on current trends, the number of women diagnosed with melanoma is projected to increase by a factor of between 93% and 175% in the period up to 2040 and, in the same period, the increase for men could be of the order of between 134% and 327%. This is a significant threat to the future health and well-being of our people and requires urgent action. I am sure everyone agrees prevention is better than cure.

There are approximately 150 fatalities per year from melanoma, with approximately 7,000 people living with this disease in Ireland. These are not mere statistics. Behind each of these numbers are people fighting painful and debilitating cancers. Many of them are winning that fight, but far too many are losing. The impact of these cancers on individuals and their families cannot be underestimated. Long-term treatment and its cost on individuals, families and the health system are significant. Data from the HSE indicates that the cost of treating skin cancer ranges from €6,000 to €10,000 per patient, depending on the complexity of the disease. New high-tech oncology drugs, such as ipilimumab, have become available recently. This treatment is effective in a number of cases, but is extremely expensive. It costs between €50,000 and €80,000 to treat each patient with this drug. Between 60 and 80 patients present with such advanced melanomas each year.

Skin cancer is preventable in many cases. If we take the proper precautions and protect ourselves and our children, we can avoid much of this disease. It is a threat that must be tackled now to prevent the harm that exposure to UV radiation causes and to reduce future costs to the health system. For most people, the main source of exposure to ultra-violet radiation is the sun. UV, ultra-violet, radiation is responsible for up to 90% of skin cancers and most UV damage is caused during childhood and adolescence. A child's skin is most sensitive to UV radiation. Up to 80% of a person's total life-time UV exposure is accumulated in childhood. Therefore, protecting children from the damaging effects of UV radiation is very important.

Many people are exposed to high doses of UV radiation through artificial sources. Sunbeds and sunlamps used for tanning purposes are the main source of deliberate exposure to artificial UV radiation. All forms of such radiation contribute to skin cancer. There has been a growing body of evidence over recent years that the use of sunbeds, especially by children, should be restricted because of the associated increased risk of skin cancer and other health problems. Other expert recommendations include ensuring that protective eyewear is provided to users; that users are informed of the health risks associated with the use of sunbeds; and that sunbed operators are prohibited from attributing health benefits to sunbed use.

The World Health Organization's International Agency for Research on Cancer is a recognised leading expert scientific body charged with providing evidence-based science to underpin global cancer control policies. In 2009, the agency reclassified UV-emitting tanning devices from a group 2A carcinogen - one that is probably carcinogenic to humans - to a group 1 carcinogen - one that is carcinogenic to humans. In 2009, the chief medical officer conducted a review of the international literature on health effects associated with the use of ultra-violet emitting tanning devices. He found that the medical evidence justifies a complete prohibition on the use of sunbeds by children up to 18 years of age, based on the significantly increased risks associated with exposure to ultra-violet radiation in early years. The CMO recommended that the issue of the increased risk posed by UV radiation for certain sub­groups of the adult population could be dealt with by way of regulation and awareness raising.

Healthy Ireland is the Government framework that sets out our vision to improve the health and well-being of the population. To realise this vision, Healthy Ireland will draw on existing policies, such as the strategy for cancer control in Ireland, but it will also go further by instituting new arrangements to ensure more effective co-operation to achieve better outcomes for all in reducing the incidence of skin cancers. Achieving the goals set out in Healthy Ireland requires composite solutions. The banning of the use of sunbeds for children under 18 years of age and regulating their use for those over 18 is an important initiative. Targeted interventions such as these will, in the long term, reap rewards and foster healthier living. Healthy Ireland will help to raise awareness on issues, such as the dangers associated with sunbed use, and will help promote healthy lifestyle choices by building on this legislation and by supporting and monitoring collaboration between areas such as primary care, hospitals, cancer screening and clinical programmes. Prevention is always better than cure, and a lot less painful.

The primary purpose of this Bill is to protect children by prohibiting the use of sunbeds on sunbed premises by those under 18 years of age and to regulate the use of sunbeds by those over 18 years of age. Our aim is to contribute to the long-term goal of reducing skin cancer rates. The Bill makes the following provisions. It makes it an offence to sell or hire a sunbed to a person aged under the age of 18 or to allow them to use a sunbed on a sunbed premises.

It promotes greater public awareness about the risks of sunbed use across all ages and prohibits unsupervised use of sunbeds in commercial premises. It provides for an exemption to allow the use of ultraviolet radiation for the medical treatment of specific skin conditions such as dermatitis and psoriasis in both children and adults. This exemption is limited to treatment involving phototherapy provided under the supervision or direction of a relevant registered medical specialist such as a dermatologist. The treatment must be provided by a health care establishment.

The Bill sets out mandatory requirements for protective eyewear. This is an important provision, as the eyes are particularly vulnerable to damage from ultraviolet radiation exposure. The Bill also sets out certain hygiene requirements for sunbeds and sunbed premises.

To protect public health, the Bill prohibits certain marketing practices such as allowing a customer who rents a sunbed for four weeks to get one week free, or offering early-bird deals. These offers are commonplace and incentivise clients to opt for a greater number of sessions than they might have originally intended.

The Bill prohibits the use of health claims other than those that may be prescribed by way of regulations. It has been common for sunbed operators to claim certain health benefits for sunbed use. Some claim an increase in the production of vitamin D as a result of sunbed use. The World Health Organization states "incidental exposure to the sun, combined with normal dietary intake of vitamin D, provides adequate vitamin D for a healthy body throughout the year". Overall, the serious health risks associated with sunbed use significantly outweigh any claimed benefits.

This Bill is also aimed at raising awareness and helping sunbed users to make more informed choices. As I have said many times, this is not a nanny State and we do not intend to forbid or ban adults from using the devices. We will, however, ensure clients are fully informed of the risks involved in using sunbeds so that they can make an informed choice. To this end, the Bill requires sunbed operators to display warning signs on sunbed premises and social media sites. The mandatory warning signs will inform the public of the health risks associated with sunbed use. The operator of a sunbed business will be required to provide information on the risks of sunbed use to potential sunbed users. This information will be required to be in written form. The operator must also ensure the potential client has read and considered the information and has signed the form before using the sunbed.

The Bill requires that those supervising the operation, sale or hire of sunbeds should be trained. Training will cover issues such as the risks of sunbed use, proper screening for potentially exposure-limiting conditions and emergency procedures in case of overexposure to ultraviolet radiation. To ensure the Bill affords the protection we intend, we have provided for an effective enforcement regime. To this end, all sunbed operators, including sellers and hirers, will be required to notify the Health Service Executive or its successor stating they provide sunbeds for use, sale or hire. The notification fee will also be provided for. To underpin the effective enforcement of this important public health legislation, comprehensive powers are set out in the Bill. Environmental health officers who have a proven record in enforcement of food safety and tobacco control legislation will be appointed as authorised officers by the HSE. They will have appropriate enforcement powers to carry out inspections and investigations to verify compliance with this legislation.

A regime for fixed payment notices - on-the-spot fines - for certain offences will be introduced. This sanction will allow environmental health officers to deal quickly and effectively with non-compliance with the legislation. It is important that the penalties for failure to comply with the legislation are both proportionate and sufficient to encourage compliance. The Bill provides for fines of up to €5,000 and terms of imprisonment of up to 12 months. The HSE may also publish a sunbed non-compliance list that will, in effect, name and shame offenders.

The Government is committed to reforming the health service to focus more proactively on promoting health and well-being. This Bill represents an important step in that direction by ensuring our children are protected from the harmful effects of sunbeds and by supporting adults in making better-informed decisions about sunbed use.

Prevention is better than cure. Approximately 150 Irish citizens pass away each year from melanoma alone, 7,000 people are living with melanoma, and there are many thousands who have other forms of skin cancer. This represents a heavy burden on those individuals and their families and also on the health service. If we are to begin to address the spiralling increase in skin cancer rates, we must act now. The statistics I have provided are on what we do currently. We can alter the future by taking action now to ensure future statistics are nothing like those of today. I commend this Bill to the House as a real sign of our collective commitment to ensuring prevention rather than just paying lip service to it.