Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I have tried in my opening remarks although the Minister may not see it, to be balanced and fair. I will try it again. The Minister may not appreciate it but it is very difficult when so much of what is presented to us, certainly as Opposition health spokespersons, can reflect negative and, in some instances, disturbing experiences.

I will start again, as I have attributed, rightly, great credit to our front-line care providers in various health care settings, by saying that I welcome very much the indication of significant savings in the overall drugs bill to the HSE. In the period 2012 through 2014, we are looking at a significant reduction in the total of the primary care reimbursement in regard to drugs. That is the result of a focused address of the issue, but much more can be achieved. That was acknowledged by the Minister's predecessor and I have no doubt it is his own view. Having welcomed the savings to date, I would like to know if further engagements are intended with the Irish Pharmaceutical Healthcare Association on proprietary drugs and with the Association of Pharmaceutical Manufacturers in Ireland in regard to generic drugs. What further engagements does the Minister intend to have? Is he seeking to achieve new and increased savings through agreement with both these bodies?

It is important to note that the figures that were shared with us demonstrate that over the period of the first decade since the turn of the millennium, there was a more than doubling in the number of individual prescribed items across the State. While the IPHA and APMI are undoubtedly to be focused on in regard to cost, is it the case that there is ongoing or intended engagement with GP representative organisations to responsibly address this issue to ensure that the most thoughtful and careful consideration goes into prescribing? The Minister is a doctor himself. I would like to know if he has intentions in that regard and if he considers that there is a need to address the significant increase in prescribing. Does he believe there is an element of over-prescribing in all of this that warrants focused attention?

On the cost of drugs and the nine State basket whereby we determine the median position, I have urged the Minister's predecessors to consider the potential of moving from the median position to the lowest with all of the resultant savings that would accrue to the Exchequer and the health spend. Has the Minister considered that and does he intend to engage in that regard? I ask him to give me some information on this.

I take the opportunity again in order to be balanced to welcome yesterday's HSE decision on Soliris and PNH which followed its recent engagement with the manufacturers. It must be a phenomenal relief to that small number of sufferers outside the ten who are being catered for through the St. James's Hospital arrangements. I commend the decision. There are other products which have had pharmaco-economic assessments. Does the decision on Soliris and PNH indicate a relaxation in that regard and suggest that other critically important products to the health and well-being of other sufferers of other challenges in life might expect a similar response?

The time is limited and we are trying to cover three areas in this new format. As such, will the Chairman allow me to move on to the acute hospitals and waiting lists?