Jan O'Sullivan (Limerick East, Labour)

The McCarthy report presented a wide menu of options, which would have provided more savings than the Government decided on. Mr. Colm McCarthy did not say the Government had to introduce all the measures he suggested under different headings in each Department. The Minister will have done a great deal to reduce the cost of drugs when she introduces generic substitution and reference pricing. She does not have to be too zealous in embracing everything Mr. McCarthy suggested should be done in her Department. Other Ministers have managed to avoid making cuts proposed by him. The Minister will say the Department has behaved responsibly but it has been over zealous in responding to the report. It would have made more sense for her to review the impact of reference pricing and generic substitution to see if she had managed to achieve savings after a set period without having to hit those who will be affected by this legislation.

I question the Minister's assertion that by imposing a charge, behaviour will change and people will seek fewer drugs from their doctor, thereby saving money. Other countries have found that has not happened when adopting similar measures and that is one of the reasons Wales and Northern Ireland, for example, are going back on the measures they introduced.

The self-care movement in Britain is much more about people's motivation and need for drugs rather than behavioural change and that might be a more useful road to go down. The health supplements in many newspapers give a great deal of coverage to lifestyle, exercise, diet and so on and point out that addressing these issues can change people's dependence on drugs. I am conscious I am straying into an area in which Deputy Reilly is more expert but the State is more likely to reduce people's dependence on the use of drugs by getting through to them about how they think about themselves, how they behave and live, their lifestyle choices and so on rather than by imposing a blunt instrument such as a charge of 50 cent every time they fill a prescription. A better result might have been achieved and it might not have been as difficult for those on low incomes to have considered the changes reference pricing and generic substitution could bring rather than trying to do everything that Mr. Colm McCarthy proposed in one go while in the process inflicting financial hardship on them.

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