2026-06-17

I call Deputy Ged Nash to move amendment No. 1 which arises out of committee proceedings.

I move amendment No. 1: In page 5, between lines 31 and 32, to insert the following: “(7) For the purposes of this section, a person is not precluded from being in complete remission by reason only of the fact that the person is receiving— (a) anti-hormonal medications, or (b) any form of preventative therapy or medicine intended to reduce the risk of recurrence of cancer following the end of active cancer treatment.” I thank the Minister of State for the way in which he has engaged with me on this matter in recent days. I think he accepts that we in the Labour Party proposed this amendment in good faith. I might describe it as a belt and braces approach to the particular provision in the Bill. The intention is to strengthen and galvanise it and ensure there is no ambiguity in any respect in terms of how this provision is interpreted by the insurance industry when people are in the position that they ought to have access to disregards and where there may be issues around it, intentional or otherwise. I think the Minister of State accepts this was proposed in good faith and in the spirit that we want to see the full Bill implemented so that there will not be any ambiguity whatsoever about any definitions in it, such as about what "remission" or "five years beyond active treatment" mean because those two tests are contained in the Bill. I am aware the Minister of State has received clear advice on his view there is no ambiguity and that the full intention and spirit of the Bill will be implemented. However, this is designed to avoid any ambiguity that might arise, especially in relation to the requirement of some cancer survivors who are in remission to receive ongoing hormonal treatment. That would apply, as the Minister of State is aware, primarily in the case of breast cancer survivors who have had a HER2-positive diagnosis and also in the case of some prostate cancers that are typically hormonally-driven and require the taking of medication on an ongoing basis. I would appreciate it if the Minister of State would put on record his position on the amendment. It would be a worthwhile exercise in itself just to establish the advice he has. I ask him to provide some clarity on his position on this and some reassurance that the Bill and the provision as currently drafted is, for want of a better description, bulletproof.

I put on record the strong support of the Social Democrats for this Bill. I compliment the Minister of State, Deputy Ardagh, and all who have worked on this on a cross-party basis, including the Irish Cancer Society and the volunteers from that society. It is an excellent example of how this Oireachtas can and should work very effectively. We need to see more of this approach to legislation progressing not just from Cabinet but from backbenchers across the Oireachtas. I support Deputy Nash's amendment. It is a very good effort to try to ensure there is not ambiguity in the Bill and he raises an important point.

To the Deputy's latter point, I am always open to good suggestions from the Opposition; I am just not sure it always come forward with them. I say that in jest.

I know.

In all seriousness, I acknowledge all Members of the Dáil in terms of their co-operation and their positive engagement on this legislation since it was first introduced by my colleague the Minister of State, Deputy Ardagh, when she was a backbench TD. I fully appreciate the amendment is coming from a position of good faith and I am not at all questioning Deputy Nash's bona fides in relation to the reason for advancing it. The Government has considered the proposal to insert a new subsection that would provide a person shall not be regarded as precluded from being in complete remission solely by reason of receiving anti-hormonal medications or preventative therapies or medicine and understands the underlying concern this is aimed at addressing. While the intent of the amendment is acknowledged and understood, the Government does not consider it necessary to include this provision as the legislation provides "complete remission" is determined by an oncologist on request. The five-year threshold only applies to primary treatment such as surgery or chemotherapy, which is considered "active cancer treatment". Anti-hormonal medications or any form of preventative therapy or medicine intended to reduce the risk of reoccurrence of cancer following the end of active cancer treatment are excluded from consideration for the disregard. For example, industry has clarified that an applicant who had surgery for breast cancer five years ago and is certified as being in complete remission by an oncologist but still takes anti-hormonal medication would qualify for the disregard under this legislation. The Bill as amended clearly defines "active cancer treatment" in section 3 and explicitly provides this does not include anti-hormonal medications or any form of preventative therapy or medicine intended to reduce the risk of reoccurrence following the end of active treatment. Individuals who are receiving these therapies or medications are already regarded, for the purpose of this Bill, as having completed active cancer treatment where all other criteria are met. The Bill therefore already accommodates the scenario where an applicant is no longer being treated for cancer and is in remission but may be taking medication or undergoing therapy for preventative reoccurrence. Officials in my Department engaged with the Office of the Parliamentary Counsel to the Government, representatives of the insurance industry, the Irish Society of Medical Oncology, the Society of Actuaries in Ireland and very importantly, the Irish Cancer Society, which the Deputy has engaged with, on this definition. The result of this consultation is a definition that closely follows that of the voluntary code. Additional consultation with industry has certified that, in practice, insurers do not consider medication to prevent reoccurrence as rendering applicants ineligible. Consequently, I do not propose to accept the amendment despite the Deputy's good intentions.

The Bill will now be sent to the Seanad. Congratulations to all concerned. It is one of my favourite times to be in the Chair.