Mr. Peter Murphy:

As Mr. Glynn stated, we have started the process of educating health professionals, including pharmacists, and getting the message across that AEDs are to be treated differently than, as Dr. Widdess-Walsh has noted, the likes of blood pressure medications, cholesterol drugs and so on. It is a long process and I do not believe this message can be promulgated in a matter of weeks or months. There is much education to be done both for health professionals, including pharmacists and general practitioners, and for people with epilepsy. This is a highly complicated area and it is important to be aware that many people with epilepsy do not necessarily understand the significance of switching. People are not necessarily going to be vigilant in the long term. The question is whether they will be assertive enough, when visiting their GP, to insist the words "Do not substitute" are written on the prescription as the Bill currently provides. The Minister will argue the words "Do not substitute", as provided for in section 13 of the current Bill, is a measure that should satisfy our concerns. The argument is that a GP or a prescriber can write "Do not substitute" and the problem is solved. This is not the case and as we have seen, pharmacists already are beginning the process of switching despite the absence of legislation and of interchangeable lists. If the Bill goes through as it currently stands, our role will not be limited to educating pharmacists. We also will be obliged to conduct what I would call an unnecessary educational process to get across the message to the tens of thousands of people with epilepsy in Ireland that they will need to insist to their doctors that the words "Do not substitute" are written on their prescriptions. In my opinion, this certainly is placing too much of an onus on the patients to look after their own health care in a complicated issues such as this one. Moreover, in recent weeks alone, we have received approximately ten separate reports directly from people with epilepsy of switching actually having taken place. A number of those concerned have allowed us to use the details to highlight this condition.