Mr. Robert Watt:

You raise a fundamental question, Chair. First, based on prescription patterns, an awful lot of drugs are prescribed. I have the number of 60 million prescriptions a year in the GMS system in this country in my head. I do not know if that encompasses drugs under the refund scheme as well, but the figure may encompass both. There is a very significant level of prescription and it is a worry if it is inappropriate prescribing. The overall cost now is very expensive at €2.5 billion and it is increasing by 5.5% a year, which is not sustainable. The cost is not sustainable and the level of drugs being taken is an issue as well. We negotiated a deal with the Irish Pharmaceutical Healthcare Association, IPHA, which the Government will sign off soon for an enhanced scheme to reduce the price, but we need to push ahead with more prescribing of generic, off-patent drugs, biosimilars and so on. There is a big job of work to do in that regard.

You also raise an interesting question, Chair. Public health officials who work in the public system cannot receive any hospitality or supports from anybody beyond a certain level covered by the ethics legislation. GPs are not public servants, even though a lot of their income is funded by the public system. I do not know whether the Irish Medical Organisation, IMO, or other bodies have ethics guidelines to ensure that people are not unduly influenced when it comes to their prescribing patterns, but I imagine it is not an issue. It is a good point.