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

I welcome the Commissioner and thank him for his presentation. Many of my questions follow on from those of Deputy Durkan. I am a pharmacist by profession so my view might be a little bit skewed and biased. I would like to follow on from the Commissioner's comments on antibiotics in pig meat. For a long time I have had an issue with powdered antibiotics being put into feeds for chickens and pigs in Ireland, in what to my knowledge has been a fairly unregulated manner. One of the issues I have is that oral medicines in Ireland, including oral antibiotics, are subject to a 0% rate of VAT while injectable medicines are subject to a 23% rate of VAT. For me, there is something wrong when a product such as a bulk antibiotic is not subject to VAT but a vaccine is subject to 23% VAT. I have inquired about it and I have been told that how we apply our VAT rate to products is decided at EU level.

Does the witness have any thoughts on that? It seems to me bizarre that it is almost incentiving a product by not having VAT on it. Perhaps I am looking at this from a naive perspective, but if there was VAT on oral or powdered antibiotics for bulk feeds, there would be a better method of tracking how much is being used. If it was per kilo or whatever, one would be able to quantify how much is actually being used in the market. Does the witness have any views on that?

The witness covered the antibiotic resistance issues quite well in response to Deputy Durkan's questions. There is no need for me to repeat any of that.

I have a family member who is a vet and I was born in rural Ireland. Therefore, I have quite an interest in agriculture. Another thing I have an issue with in light of Brexit is hormone beef coming from Brazil and Argentina, which seem to be the main countries producing high-level hormone beef. In light of Brexit, one of my concerns recently was that a UK supermarket had on its shelves only British beef. One of my concerns is how to get a message to the public. If a supermarket says that this beef is cheaper, to the consumer that is a good thing because naturally people do not want to spend as much money. I have an issue with the fact that perhaps we are not getting out the message that just because it is cheaper does not mean it is as good. There is a complete difference between hormone beef and the effect it has once ingested and assimilated and non-hormone beef. Has the witness any plans for marketing to the consumer within the EU states that cheap is not always best? Some of us know about this, but I think there is an issue in disseminating that information down to the person pushing the shopping trolley around the supermarket.

My second train of thought this morning is in regard to vaccination. Again, the witness covered it very well. It is something that is quite prevalent in Ireland at the moment. We have a serious problem in Ireland with anti-vaccine groups with online agendas. They are gaining a lot of momentum. We had the ex-Dr. Wakefield from the UK touring Ireland recently with his anti-vaccine agenda. It has caused a lot of damage. I am sure the witness is aware of our falling vaccination rates, from about 95% for the MMR down to about 92% now. We have a huge issue with our HPV vaccine rates in Ireland. Can the witness, given the EU context, give us any advice on how to counteract that? Are we in Ireland specifically exposed to this sort of "fake news", for want of a better term, or are other countries experiencing the same sort of negative campaigning against vaccines, which is clearly very serious? I have said it here many times. People on trolleys and waiting lists will be the least of our worries if there is a measles outbreak like there has been in Romania and in some of the Iberian area of Europe.

Regarding antibiotic resistance and the over-use of antibiotics, is the witness monitoring the excretion of antibiotics through urine, human or animal, into the water supply? Is he monitoring what sort of levels we have? In Ireland, we are all moving a little more towards rainwater harvesting. We are trying to deal with our waste on our own site Is the witness looking at the levels of antibiotics that are excreted by humans into our clean water supply?

It is the same with pork and chicken. Are we making our consumers aware of the complete difference between a chicken that is pumped full of hormones or chlorine and a chicken that has not had that sort of a life?

To sum up, my questions are really about disseminating the information from an EU context to the person pushing the shopping trolley around the supermarket. Has the witness any advice on how we can deal with the negative vaccine campaigns? There is also the issue of the VAT rate on oral antibiotics.

With regard to orphan drugs, we have had a lot of difficulty in this country. I do not think that anybody can deny that it is the issue coming down the track for us. The witness knows as well as I do that the orphan drug issue was not relevant in the past because there was not the seed capital to get the research going initially. However, people are now coming together globally, getting the data together and producing the orphan drugs. States can be held to ransom to some extent for a very high-price drug. Has the witness thought about this? Has he any views on that might be done to curtail the drug spend? I understand Orkambi is going to cost this State €300 million annually. We have a unique relationship in this country with cystic fibrosis. I am fully supportive of Orkambi being given. However, if there were ten drugs like Orkambi, we would be in a very serious financial situation where the annual price of a drug could be the same price as building a hospital or whatever. These are major pressures on Ireland's finances and obviously on European finances. I ask the witness to give me a little bit of information on that. If he does not have the answers here, I am willing to follow up for answers.