James Reilly (Dublin North, Fine Gael) | Oireachtas source

If I may, I will come back to some of the issues referred to by Mr. O'Brien, which are helpful. It is important to point out that non-consultant hospital doctors in their 20s and 30s often have families, so it is ludicrous to be offering them six-month contracts. That has to change and it will change. I am determined to correct this situation because it is undermining our ability to provide a health service. If we do not value those who work in our health service it will not help patient care.

Deputy Dowds raised the issue of general practice and I know there is unhappiness in that community about the cuts they have had to take. Similar levels of cuts have been imposed right across the public service. I wish to put on the record my appreciation of the great job that those in general practice do. I am committed - as is the Minister of State, Deputy Alex White - to support general practice to start working in a different way, so that it can provide even greater care. We will do that through a number of mechanisms. Clearly, however, the role of general practice nurses has to be explored much further because their capacity to deliver care in the community has not been properly taken advantage of. I believe that such a re-examination would lead to much greater job satisfaction for nurses and GPs also.

Deputy Fitzpatrick expressed concern about Drumcar, but I will let the Minister of State, Deputy Kathleen Lynch, deal with that. In a more general sense, we now have somebody in place to review many of the non-governmental organisations involved in the delivery of care. I believe there is a far better way of providing more care services at less cost. I will let the Minister of State, Deputy Lynch, deal with that matter in a more comprehensive fashion.

Deputy McLellan raised the issue of discretionary medical cards and I will let Ms Laverne McGuinness deal with that. I am happy to say that the Government has published the assisted decision-making capacity legislation to establish the Mental Health Commission. I will allow the Minister of State, Deputy Lynch, to deal with that more comprehensively.

Senator Crown has raised some important issues. As he highlighted, there are companies that provide that drug, so let the customer decide where he or she wishes to go. That is what competition is about.

As regards Senator Crown's comments on tobacco, I acknowledge that legislation takes time. Sometimes it is not as simple as it appears. Having said that, however, we have a large amount of legislation which we are trying to get through the Oireachtas. Some legislation has to come through the Department of Finance because of the troika. In addition, my productive and prodigious colleague, the Minister for Justice and Equality, Deputy Shatter, has a large amount of legislation as he tries to reform the legal system. I also have a huge amount of legislation to deal with. We spent much of yesterday in the Department discussing the need for more capacity to progress legislation.

We are striving to introduce legislation on plain packaging for tobacco products, and hope to have the heads of the Bill in September. I will return to this committee to discuss it in due course. I thank members of the committee for their support in this regard. There is a serious battle ahead because there are powerful forces at play. It is astonishing to me how anybody could put in writing their concerns about intellectual property rights over the rights of children and other citizens to enjoy good health. If that is how things were to be prioritised, it is not a society I would like to be living in.

I will ask Mr. Tony O'Brien and perhaps Ms Laverne McGuinness or Mr. Ian Carter to address the issue of cancer patients being charged. I understand there is a limit in that regard, but I will let Mr. O'Brien address that matter.

I thank Deputy Regina Doherty for her support for the women who have endured symphysiotomy.