Colm Burke (Fine Gael) | Oireachtas source

I thank those who have presented here this morning for the work they are doing. We appreciate their commitment to trying to improve the health care sector. As the Chairman has outlined, we decided to look at the increase in the prescribing of drugs on foot of media coverage of the issue. According to the paper submitted by Professor Fahey, the percentage of people over the age of 65 to whom five or more medicines are prescribed has increased from 17.8% to 60.4% and the percentage of people in this older cohort to whom ten or more medicines are prescribed has increased from 1.5% to 21.9%. I wonder how this country compares with other countries in this regard. Are comparisons available? Can what has occurred in this country in this area be compared with what has occurred in other countries in this area?

I know there have been huge demographic changes in Ireland. People are living longer. Life expectancy has increased by 2.5 years since 2000. This means we have more people over the age of 65. The number of such people will continue to increase. I am sure the witnesses have looked at the changes in demographics we will face over the next 12 years. How can we best deal with this issue? If we have more people over the age of 65, will we have an increased level of demand for medications and will costs continue to increase? The cost of medication has increased dramatically over the past ten or 15 years. I think the annual cost of pharmaceuticals was approximately €570 million in 2000, but now it is slightly over €2 billion. When there is such a substantial increase, other areas like GP funding lose out. I agree with the witnesses that the whole GP contract needs to be reformed. That needs to be fast-tracked. I have been one of the people looking for that.

The second issue I want to raise is electronic prescribing, which is used very effectively in other countries. Sample prescriptions have been given to us today. If we tried in the morning to set a target for the introduction of electronic prescribing across GPs, hospitals and pharmacies, and if the necessary funding were provided, what kind of timescale would be required for the introduction of such a system? Should we be setting targets to be achieved? My concern about health care is that we seem to be doing budgets on a year-to-year basis without also doing long-term planning. We have lost out in the whole area of electronic records. Someone who goes to three different hospitals will have three different files. The same point can be made with regard to prescribing. I wonder whether we can set targets and, if so, what kind of timescale would be required for us to implement those targets.

My final point relates to the substantial increase in the number of people applying for GP training this year. There has been a slight increase in the number of places, but this has not been substantial enough. Do the witnesses believe we can reverse the exodus of GPs out of the Irish system? If a new contract is offered, obviously it has to be attractive.

Will Ireland still compete on the world market? This is one of the problems we are now dealing with in all areas of medicine. We are no longer competing in an Irish market or a UK market, rather we are competing with Australia, New Zealand, Canada and the United States of America. What else do we need to do besides providing a new contract? What else do we need to do to keep medical personnel in Ireland and to provide a better level of service at community level?