Mary Harney (Dublin Mid West, Independent)

Co-payments are in operation from Australia to the United States and in many European countries. There is no evidence to suggest that when people make a co-payment, they do not take their essential medicines. I referred earlier to research from Holland in 1998. The reason I included children in care is that as the HSE pays for those children, there is no point in having a circular movement of the money in which one would be obliged to reimburse foster care parents or children in institutional care where medication is procured on their behalf.

For obvious reasons we want people to take their methadone. Those patients are a definable group. I have some sympathy with the homeless. Homeless people living in hostels or in institutional accommodation will not be obliged to pay the charge because their medication is procured by the institution on a generic medical card for the institution and the charge will not apply there. I would have wished to have excluded other homeless people but they are not identifiable. This has been confirmed by the HSE. I have the power under regulations to look at categories of people for exclusion, for example, women who have had symphysiotomies or thalidomide sufferers, because they are identifiable or perhaps asylum seekers who only get €19 per week because of the direct provision. These are categories of people we can exclude. The vast majority of people with mental illness, psychiatric patients, do not have medical cards and do pay for their medication.

Senator Feeney made the point in the other House that we need to eat and drink to survive and there is no suggestion that because people have to pay for food, they do not buy it.

See this speech in context