Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I thank the delegates for their evidence. Some months ago Senator Tony Mulcahy bent my ear on this issue and he has been pressing a number of us on it in recent months. What we are discussing is not alien to most of us. Our former colleague, the late Senator and Deputy Joe Doyle, had epilepsy. He was a great advocate for people with epilepsy and a great role model.

What is the legal position in the United Kingdom? Is the system based on primary legislation, regulations or guidelines? Will the delegates furnish the committee with the wording, be it in a regulation, statutory instrument or primary legislation? This would be helpful in our consideration of the Bill because of the similar legislative processes in both jurisdictions.

My next question concerns the fact that switching is taking place. Some pharmacists are switching, although the legislation is not in place. It has already given rise to difficulties. I refer not only to the point made on epilepsy. The point made this morning was very valid and is one we will be putting to the Minister next week. If one is taking only one type of medicine, switching may not have a huge impact, but many older people who may be on 14 or 15 types of medicines may be affected. If a medicine is being substituted, the pharmacist should explain to the patient or his or her family that this is the case. It is important that it be explained to patients that a particular medicine is being prescribed for them. To avoid confusion, they ought to know whether their heart or epilepsy medicine, for example, is being substituted.

Is it not better to have a provision in the legislation that would tie a pharmacist to prescribing a specific medicine? The delegation made a very strong case for patients with epilepsy. There will be a very small cohort who, for one reason or another, will have suffered adverse effects on moving to another formulation of medicine, although the active ingredient will have been the same. The last outcome one wants is a set of circumstances in which the patient must try, every time he or she enters the pharmacy, to convince the pharmacist that he or she needs a particular type of medicine. Should we focus purely on AEDs or should we table an amendment that would allow the doctor or consultant to stipulate that a certain medicine should not be changed in any circumstance because of the patient's particular illness or the characteristics thereof? I include people with epilepsy but also a very small cohort who, for various reasons, may not be able to adapt to changes in the formulation of their medication.