Mr. Robert Watt:

It relates to reference pricing. We agree with Deputy Fleming. If one looks at the latest figures, the GMS is costing over €2 billion. A total of 1.8 million people have medical cards. The cost of drugs per medical card recipient is almost €700 per year and that is the average. That seems an incredible number. There are many issues here, as the Deputy is aware. The generic issue is an obvious one. I know colleagues in the Department of Health and the HSE are working on this. There is the question of the reference pricing and the deal we did with manufacturers. We have a fairly simple view on this. The State has monopoly in this market as in others. We have buyer power because of our size. We are the largest purchaser of many goods including drugs so our view is that we need to use that market power. We would press our colleagues in the Department of Health and the HSE all the time. If one looks at the difficulties within the health system, one can see they are taking cost out all the time and demand is going up right across. There are enormous increases in productivity. The key challenge is to keep the service going when we continue to take out costs. This is an area where savings are not as painful as many options of which the Deputy is aware. It is something we do press our colleagues in the health system on and we are working with them on it.