Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

Many different circumstances could arise. Section 13 clearly provides that in order to preclude substitution, the "prescriber shall write, legibly and by hand, "do not substitute" on the prescription". That could leave it open for the patient or someone else to write "do not substitute" on the prescription. I know that would be of concern. Is there a way of addressing that? Is a sanction being provided for? I would also like clarity on what will happen in the event of a pharmacist being unsure of the authenticity or veracity of a handwritten note that says "do not substitute". What mechanism will be available to the pharmacist to address such concerns? Will he or she be able to pick up the telephone and ring the prescribing doctor, or will the patient have to go back to the GP? I am asking these questions because it is clear that many people are attached to the medicines they are on. We all know people who only want the blue tablet or the green tablet and no other colour tablet will do them. If, after we include this provision in legislation, a doctor makes a clinical decision that the person's medicine is suitable for substitution, it will be very easy for a patient to write "do not substitute" on the prescription in nice legible handwriting to ensure no change is made. As the Minister of State knows, such handwriting is totally different from medical handwriting. Obviously, that should be an offence. I am concerned to ensure pharmacists who sense that a prescription has been amended will be able to take action to confirm the authenticity of the request. If they find it is not an authentic request while they have the prescription at hand, will they be able to override it by means of verbal contact with the prescribing GP?