An Cathaoirleach: The purpose of today's meeting is to consider the funding and implementation of the national cancer strategy. The meeting will be divided into two sessions. We will hear first from representatives of the Irish Cancer Society, ICS, following which we will engage with witnesses from the Health Service Executive, HSE. I am pleased to welcome Ms Averil Power, chief executive officer; Ms Emma Harte, policy and campaigns manager; and Mr. John Kennedy, MB FRCPI, consultant medical oncologist and co-director at Trinity St. James's Cancer Institute, ICS…..

Deputy Róisín Shortall: It was also mentioned earlier that the rates of cancer are increasing, partly because of a growing and ageing population.

Is it possible to disaggregate those factors and look at the social and commercial determinants in the context of cancer rates? We had a session here a couple of months ago on the commercial determinants. It is an uneven contest between health messages and the commercial advertising of alcohol, vaping, fast food, highly processed foods and all that, given the multi-billion euro advertising budgets. Is the ICS proposing anything specific on that area, where the Government could step in and, through legislation, limit access to those factors that impact the rates of cancer?

Ms Averil Power: As I said, cancer prevention is a massive priority for us. It was called out as one of the key recommendations in the national cancer strategy because four out of ten cancers are preventable through lifestyle changes like a proper diet, reduced alcohol intake, not smoking and all those factors. There have been some positive improvements. For example, the alcohol restrictions, such as alcohol labelling, which we supported, that have been introduced in recent years have been positive.

We are very frustrated by the lack of progress on tackling youth vaping and the massive damage that is doing. I know the committee has looked at the matter in terms of the undermining of decades of incredibly positive work in Ireland to tackle youth smoking and that a vaping epidemic has been allowed to happen. I know that positive steps have been taken by the Minister in terms of supply restrictions through age restrictions and things like that. Deputy Shortall has hit on the point that unless the relentless market targeting of vaping products at children, and of unhealthy foods at everybody, is tackled, we will not really get to the core of the issue.

As Professor Kennedy said, part of health outcomes in disadvantaged areas is down to inequalities in terms of access to healthy food and part of it is health behaviours. We have to find a targeted and effective way of dealing with that. It is crazy when one compares the marketing might of those industries, as the Deputy has done in terms of looking at the commercial determinants, with the work the State is trying to do in public health. Public health messaging is important but we would also say that people know that smoking is bad for them. It does no good for the State and the ICS to tell people smoking is bad for them if they are not being given proper support to help them to quit. The ICS saying people need to eat better is no use if people cannot afford to eat better. It is no use telling kids they need to eat better while at the same time they are being bombarded with advertising point-of-sale marketing for unhealthy foods. We have to look at this issue in the round.

Seán Crowe, An Cathaoirleach: It is a matter of deep frustration for the committee because we set aside a lot of our work to discuss vaping. We were told that legislation on vaping was going to be a priority. We, as a committee, prioritised the legislation and rushed it through but now it is sitting on someone's desk. Hopefully, the Minister or someone in his office might be listening and will take the initiative to fast-track the Bill.

Deputy Neasa Hourigan: I do not think any of us on the committee have let go of the issue of advertising and vaping flavours being specifically targeted towards teenagers. We will continue to follow up on the matter.

I want to get clarity because we have witnesses coming in on some of the numbers. It was stated in a previous contribution regarding the years in which there is a shortfall, and notwithstanding the aftermath of Covid, that the shortfall is in the region of €20 million. We got additional information from the Department. It stated that €54.1 million in new development funding has been allocated since 2017. The Department suggests that between 2017 and 2022 there were specific packages of funding towards recruitment. I invite our guests to unpack this for me. The document provided by the Department states, "New development funding from 2017 to 2022 has been used to recruit an additional 742 staff to national cancer services."

There is no update for 2023 or 2024. Can I infer that there is no stand-alone funding targeting recruitment issues?

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