Mr. Pat O'Mahony:

Antibiotics come into the mix as well in discussions. Senator Crown referred to the need to control antibiotics to prevent the emergence of bacterial resistance. There is probably enough evidence to support the contention that we are over-prescribing in certain areas. The question is what one does if one is a busy GP and somebody comes to the practice with an expectation of a prescription, given our current culture. Will the person go down the road and get a prescription elsewhere? The medical profession must have such a debate in terms of their practice. The debate in that regard is ongoing.

One of the issues that has been discussed internationally, which is worth examining, is the area of medication reviews. It is not exactly our remit but we are interested in the area. If a patient is on a complicated regime of five, six or seven medicines, and he or she visits a GP on a monthly basis and has the prescriptions renewed and then the pharmacist dispenses the medicines, in some countries there is another dialogue, perhaps at the level of the pharmacy, to talk about the overall basket of medication he or she is taking. One might find that he or she is no longer taking one or other of the medicines because in his or her judgment it is not doing them any good or does not suit them. The medicine is still being dispensed and is still a cost to the state. The concept of medication reviews in a planned way is something that should also be examined in the evolution of this area.