John Crown (Independent) | Oireachtas source

In reply to my question the Minister stated that these NCPE assessments were in the public domain and, as a result, Aviva had the same right to consult them as anybody else. I was in touch with somebody from Aviva yesterday who told me that it is paying the NCPE for access to the reports. That is a service, which is a legitimate activity for the NCPE to do if it can raise revenues, but there is something seriously wrong with a system where a taxpayer-funded organisation is doing analyses which private for-profit insurance companies are then using to justify not paying for something and putting that burden back on an incredibly overburdened public health service.

I thank the Minister for his reply. I acknowledge his attention to our ban on smoking in cars where children are present. We are working together on that and I am very grateful to the Minister and his Government for allowing the Bill pass through Second Stage; it is hoped the Bill will complete Committee Stage in the near future. I remind the Minister that we had meetings with some of his senior officials towards the beginning of January in which we were told we would have the Bill by the end of January. Six months have passed, although I know other important legislative issues have arisen.

The Minister keeps referring to the heads of the Bill but there is a Bill; the Bill is written. What we are talking about are amendments to the Bill. Perhaps I am legislatively naive on that. I do not know if an entirely different Bill is being proposed or if heads of a Bill are coming forward. There is a very good reason politically to have this Bill passed by the Houses. The Minister is a campaigning anti-tobacco Minister and legislator but at this point in time the only Bill that has been passed is one which makes it easier to sell cigarettes by ending the ban on below-price selling.

On the health technology assessment for defibrillators, Frank Pantridge, an Irishman, invented the portable defibrillator. He was a cardiologist in Belfast. It was used widely since 1967. I remain a little troubled by the fact that we need a health technology assessment done on it.

With respect to the medical cards, I am not asking the Minister a question but I do not often get a chance to bring issues to his attention, and this is important. Public patients receiving repetitive cancer treatment who do not have medical cards are being charged repetitively for coming into hospital for different treatments. That is grounds for thinking that the discretionary medical card should be extended to patients who have cancer who are on active treatment. Some of it makes bad health economics. We have stopped paying for a drug called G-CSF, on which I had the privilege of being involved in some of the developmental research about 25 years ago. That drug reduces the rate of expensive readmission to hospital of cancer chemotherapy patients by reducing their risk of potentially life-threatening infections. This decision will cost money. More patients will be admitted to the hospital with complications of infections from chemotherapy than would have happened if they were given what is now a relative cheap injection.

All the rhetoric about the non-consultant hospital doctors, NCHDs, could be ended with the stroke of a pen if the Minister made the decision that, in future, all non-consultant hospital doctor titles - intern, senior house officer, SHO, registrar - would be scrapped and they would be called trainee 1, trainee 2, trainee 3 or trainee 15 by the year they graduated from medical school. It would remind people that NCHDs are there to train. They are not there to provide a service for anyone.