Professor Tom Fahey:

On Deputy Harty's first comment, generally speaking, I hold my clinics, see my patients, do some house calls and I then update my repeat prescriptions. Usually, I see between ten and 15 people per morning clinic such that the clinic mentioned was a fairly typical one. On prescription pattern monitoring and audit of usage, this script is not that bad; it is possible to read it. What the Deputy is doing is trying to surmise the indication for these drugs but the indication is not on this prescription. Under the current system, the prescription of a drug is not linked to a diagnostic code for indication. This is something we should have because it enables people, either in the community or the hospital sector, to make more rational decisions about the need for a prescription and to have a meaningful discussion with the patient. If we had an interoperable system that spoke to the hospital system, we could then make a joint decision or at least identify that a person has been in a hospital and was refused a drug for a particular reason.

The system around prescribing needs to be enhanced in the short term. Education and training in Ireland is reasonably okay, but it can always be improved. The systems around supporting prescriptions in the community, dispensing pharmacies and hospitals is lagging behind and this should be addressed.