Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I thank the Minister for appearing before the committee. The first issue I want to speak about is the State Claims Agency, which is mentioned in regard to budgets. I want to focus on maternity care, in particular cases where a woman goes into a hospital to deliver a child and something goes wrong at the birth, for whatever reason - I am not saying it is the fault of the HSE or a doctor. I would like to highlight to the committee and the Minister the process women and families have to go through when mistakes, alleged or otherwise, are made.

The Minister referred to the national maternity strategy. When women go into hospital to have children and something goes wrong, they have to go home and deal with children who, while they are alive, may have a disability as a result of birth. Women and families have to go through a process to be heard. Parents do not expect this to happen to them and they have children to care for who may need additional physiotherapy and all sorts of care.

The process involves State legal teams, and women also have their own legal teams. Every gynaecological examination needs to be done by two sets of people. Life is bad enough for the women this has happened to and who have been left with children to care for. The State helps in terms of the provision of services such as the Central Remedial Clinic or whatever. It is something on which we need to work.

It is bbarbaric that a woman would have to be examined from head to toe, foot to knee or wherever by two separate sets of medical experts. To my mind, women are degraded and demeaned by that.

It is something, for the sake of the women of this country, that we need to consider and speed up this process. If something has gone wrong then we must learn lessons from the incident. From the patient's point of view, the process has huge mental health implications. People may say they are well and do not intend to pursue the matter further.

Deputy Louise O'Reilly mentioned the HSE structures and a tweet by Fergal Bowers that I did not see. I strongly advise against anything like that happening while the work of the ten-year health committee is ongoing. I am on the committee, as is Deputy Louise O'Reilly. Who else here is on it? It would be regressive if the HSE went about fixing itself without the involvement of the Committee on the Future of Healthcare because that is the purpose behind the establishment of the committee.

It is great news that 80 consultants have been recruited this year. I agree with the Minister that things other than pay matter to people. For example, training opportunities, grant supports and clear career pathways from junior doctor to the Holy Grail of being a hospital consultant. Appointment to a consultant position is usually the ultimate aim of dedicated clinicians. It is imperative that we support career pathways and do not lose people that have been educated in this country. My sister is a hospital consultant and she emigrated to Australia. I am sure she cost the State a fortune to educate but she will never return. We must look at recruitment. We need to provide support to junior doctors and non-hospital consultant doctors in order for them to progress in their careers. One of the great failings of the health system is that we do not have enough indigenous trained medical people who are used to our system. Instead, they are leaving the country.

In terms of drug pricing, the Minister mentioned assisted reproduction and high-tech drugs. The Minister need not give me answers today to the following questions as I can get them off him again. Was he referring to drugs that are used for IVF or any sort of assisted reproduction? Have the drugs been removed from the high-tech list? Are they no longer allowed on the list? What is the position?

A drug called Humira is used by some hospital consultants in IVF treatment. The drug is made by AbbVie and is not licensed for IVF treatment but for another purpose. The patient must pay the full price of €1,550 for two injections of the drug. People do not like to talk about the cost associated with assisted reproduction or IVF but it is astronomical. Many of the drugs used in this process are high-tech drugs. The drugs are necessary and allow people to have much longed-for children.

My next question is on the classification of high-tech drugs. I am a community pharmacist but I used to be a hospital pharmacist. We need to consider how drugs are classified as high-tech. Ten years high-tech drugs were launched with bells and whistles, we all got very excited and we all had one small fridge. Now community pharmacies have huge fridges full of high-tech drugs. We need to consider why drugs are classified high-tech. I am not suggesting that the following is the case but perhaps drug companies are going down the route of making them high-tech when ordinarily they would fall into a different classification.

People are positive when we negotiate better deals with drug companies. I want to mention something that happened during a recent debate in the House on a motion which covered among other matters the reimbursement for blister packing or phased prescriptions. A Deputy mentioned that the synthetic cannabinoid Nabilone is used for pain relief. The item is a particularly popular with the pain consultants in St. Vincent's as one tends to see spots of drug prescribing. The reimbursement price increased from €400 to €1,200 for a monthly dose or treatment of the drug. That meant in practical terms that a patient was prescribed the drug by the doctor, got their drug from his or her community pharmacist and went home. Then the HSE rightly stopped paying for it because the price had trebled. Sometimes when the Government cuts off the supply of a drug there is a legitimate and logical reason for doing so. There are some Deputies who, on the one hand cannot say it is great that prices are going down while, on the other hand, asking for a drug to be in use. They cannot talk out of both sides of their mouths