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

It seems like we are back to somebody's point about the saving the home help system provides to acute services. If the system that has been created by whoever we want to blame for it has led to staff perhaps having the ideal qualifications and ticking the boxes in terms of employment but not being on the ground keeping an eye on things, and if that is having a negative impact on outcomes for patients and claims against the State, which we will deal with next week, it is a ridiculous equation. I cannot see why we would fail to try to address that. If the solution is permanent consultant staff who are happy to be paid, it seems an obvious course of action.

Finally, there are orphan drugs. Mr. Reid mentioned the cost of the PCRS and so on. In terms of a re-evaluating point for drugs that have been approved such as Orkambi, Spinraza and some of the more expensive drugs, I accept Spinraza has only been approved. Those are merely two examples off the top of my head. Is there any scope in the future, especially with drugs that did not necessarily meet the criteria of the National Centre for Pharmacoeconomics, NCPE, for re-evaluating the provision these drugs? Regarding the patient cohorts, is there a five-year or ten-year review process built in to see are we getting value for money? When something is approved, it is approved for ever? What if new data came out?