I move: "That the Bill be now read a Second Time."
I welcome the Minister of State to the House and 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. 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.
The reality and the message is that one size does not fit all. Drug A may not add a single day to my life and, therefore, it may not be beneficial for it to be prescribed to me. However, to Senator Darragh O'Brien, for example, it may give an extended period of remission or even cure.
What this Bill will do is simplify the process. All American Medical Association, AMA, approved drugs will be made available by the HSE, and the Minister of the day, be it the Minister of State, Deputy Kathleen Lynch, the Minister, Deputy Reilly, or whatever Minister of whatever party or future Government, must affirm or deny the access to such drug and, in doing so, can deliberate and consult the Irish Society of Medical Oncologists, the Haematology Association of Ireland, the National Centre for Pharmacoeconomics, the National Cancer Control Programme and the HSE.
Of course, the Minister of the day would not look forward to having to take a difficult decision and having to say at times that a drug would not be made available, but it would be based on very good grounds and on consultations with professionals who have the expertise to help the Minister make that determination. However, it would be up to the Minister to opt out of providing that drug rather than just opting in.
We have seen the ipilimumab, or Ipi, scenario and other scenarios, where the only recourse for vulnerable cancer patients was to resort, as I said in my press statement, to the Joe Duffy approach to obtaining cancer treatments which would prolong their lives or perhaps lead towards cure. This is an unacceptable scenario and one that is not becoming of any Government interested in representative politics and in putting the patient first.
It is time the patient was put first. We on this side of the House are very honoured and proud of the fact Senator Crown has endorsed the Bill. We believe this is legislation that puts the patient first. It certainly acknowledges that difficult decisions will have to be made by the Government of the day, but that is the responsibility of any Government. It is not about making it politically easier to lead the country. It is a difficult job and the buck must stop somewhere. The responsibility, ultimately, is to the people and, in medicine, the patient.
This simple legislation assures the patient of guaranteed access to drugs that are going to help them in the context of outcome. Of course, there are certain scenarios where a drug will be too expensive given the expected outcome or given the expected extension of life. Professor Crown will give examples of such drugs in regard to breast cancer, where consultants, because the extended period given is so small and the cost so high, understand that these issues have to be balanced. However, we cannot have a criteria based solely on cost. As I said, the criterion of cost per life saved is far too crude a methodology on which to make that assessment, for the reasons I highlighted.
I very much hope the Government can accept the Bill on Second Stage. If there are additional suggestions or improvements that can be made in areas I have missed or that Senator Crown may have missed in his consideration of these proposals, let us deal with those on Committee Stage. Let it also be a victory for the Seanad. We have had other legislation initiated here in the past that has made very worthwhile improvements, and this Bill is another such example. I appeal to colleagues, the Minister of State and the Whips to allow this legislation to be accepted today on Second Stage. It is a Bill that is patient focused and puts the patient at the centre while still preserving the very important role of the Government to take, at times, the decision not to provide a particular drug.
As we have seen with the high profile cases involving Ipi in recent times, the current situation cannot be allowed to continue and, for that reason, I commend the Bill to the House. I look forward to Members' contributions during the debate. I very much hope the Seanad can unite behind this Bill, which, as I said at the outset, is non-adversarial and non-political, and has been put forward simply in the best interests of the patient. I hope the Minister of State and Members will agree with that.