Mr. Pat O'Mahony:

I will. On the idea of preparing a chart, I have made a note of this and put an asterisk beside it. We would be very pleased to take up the suggestion of a chart to help the public understand who does what in this whole area. We can undertake to do that. I did not comment on the differences between HSE regions because we have no role or function in that regard, nor on how decisions are made on the introduction of reimbursement for a particular medicine. It is not our brief.

On whether we will be proactive on switching, while the company makes the application and then we assess it and deal with it, the reason we established the consultative panel was to draw out opinion from across the various stakeholders to raise awareness of the issue. Our ambition is that we will be able to say that in our opinion, particular classes of medicines could be delivered safely over the counter in pharmacies. We fully support the comments about the expertise available. My question is whether companies will respond to that and if legislation should be changed to facilitate it.

I was asked why companies would not want their products reimbursed. That is a complex issue. Again, it is not for me to say, but one of the big issues is that when a medicine moves from prescription-only to over-the-counter, it is no longer on the reimbursement list. Suddenly, a medicine that was prescribed by a doctor, dispensed by a pharmacy and paid for in the reimbursement scheme is no longer available and patients must pay for it themselves. That is an important issue. This is something we have raised in discussions at senior level. We must make informed choices as a country on whether certain medicines can be delivered at the OTC level in the pharmacy, with all of the supports that are available, and whether we should automatically delist them from reimbursement, because that is a disincentive to companies to agree to the change. In addition, a patient might still choose to go to the doctor and have another medicine prescribed that will be reimbursed so that they do not have to pay the pharmacy for it. Pricing is not our area, but we have suggested in discussions at a senior level that the restriction of reimbursement to prescription medicines is another area that should be examined in the current, evolving environment. That is something on which the committee might be able to take a view if it is discussing the matter with colleagues from the Department of Health or the Health Service Executive. We have raised it with them as something we consider might be significant.