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Seanad
‹ Order of Business

Cancer medical card proposal

Summary

Senators oppose reported plans to withdraw discretionary medical cards from non-terminal cancer patients and call for an urgent ministerial explanation.

While I have my differences with Senator Ó Clochartaigh, I agree with him that the reported statement in today's media by the Minister for Health, Deputy Reilly, that the Government is considering the withdrawal of medical cards from cancer patients deemed to be not terminal will cause unnecessary worry in the community. That would be a horrific decision. The HSE should get its house in order in so many other areas before calling to the door of cancer patients. This proposal should be vehemently resisted. Some clarification on this issue by the Minister would be welcome.

I call on the Leader to commend at the earliest opportunity the Minister for Justice and Equality, Deputy Shatter, on finally responding to an issue raised many times in this House during the past 18 months, including by way of two Private Member's motions, namely, the appointment of a charities regulator. This is long overdue and flows from a provision in the 2009 Act which was never implemented. It is something for which the Seanad can take some credit, having led the charge on it. The Minister, Deputy Shatter, was in this House twice during the past 18 months to respond to motions calling for the appointment of an independent charities regulator. Following wide-ranging consultation with the charities sector, which has at its disposal more than €5 billion annually in resources and includes more than 8,000 registered charities, this will happen. The appointment of an independent charities regulator is important to the sector and for public confidence in it in terms of ongoing generosity to charities.

We must ensure that the State funding invested in this area is used for the purpose for which it is intended, namely, to help people in need. I ask that the Minister attends the House to outline both the timeframe for establishing this office and the structures relating to it, in respect of which he has finally reached agreement.

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I welcome the increased scrutiny of the charity sector. It is important, however, that in increasing the level of such scrutiny, we do not put additional bureaucratic hurdles in place. That is the challenge the Minister for Justice and Equality is going to be obliged to meet. This is because, after a time, bureaucracies seek to justify their own existence by imposing all kinds of extra strictures.

I echo Senator Ó Clochartaigh's call for the Minister for Health should attend the House to clarify the appalling situation relating to discretionary medical cards being limited, in the case of cancer, to patients whose diagnosis is terminal. I never use the word "terminal" and I care for more cancer patients than pretty much anyone else in the country. I would not use the word "terminal" except in the case of someone who is literally on his or her deathbed and in that last, sad day or two of his or her journey through life. There are many patients who are incurable. The entire philosophy relating to cancer treatment is changing and that is why I am just stunned by the ignorance of the Department of Health in drawing up this new regulation. I am concerned about patients with secondary or metastatic breast cancer. Thankfully, most patients with breast cancer are cured following an operation and a course of radiotherapy but the one third who go on to develop secondary cancers are, with few exceptions, not curable. They are, however, very treatable and they will live for years. In the past, those with secondary breast cancer used to live three to six months but now the average patient lives for up to five years. Sadly, however, most still succumb to the disease. When I give somebody bad news about his or her condition, I say "This is not curable but then neither is diabetes. We treat it, you will live with it and we will do our best to keep you alive and well for as long as we can". The position is similar with regard to rheumatoid arthritis and a host of other conditions.

I am very upset by what has been done in this instance. I am of the view that it goes to the core of the problem in this regard. I am not referring to it being the Minister's fault but rather to the incompetence that exists within the Department of Health. When he comes before the House, I would like the Minister to clarify where stands the Bill introduced by Senators, van Turnhout, Daly and I in respect of smoking in cars with children. We were promised that this legislation would be passed prior to last summer's recess and we were then informed that it would be enacted before January of this year. However, there has been no progress in respect of it.

There is a need for a code of conduct within the precincts of this building. That code should be based around not closing bars but rather on the notion that it is not acceptable to drink alcohol before entering either House. In the same way that it became unacceptable to have martini-laden business lunches ten years ago or for drug representatives to bring wine to lunches with young doctors 30 years ago, it is not acceptable that Deputies and Senators should debate critical issues with a blood alcohol level of anything other than zero. I am not advocating that we should close the bars or breathalyse anyone but a change of culture is certainly required. I ask the Leader to contact the party Whips and the representatives of the Independent Senators and impress upon them that there is a real need - in the context of the decorum, good name and reputation of this House - for people to start complying with a code of practice such as that to which I refer.

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