Dr. Colm Henry:

I thank the Cathaoirleach. I will deal with the medications first. I have not seen data to show we are the second slowest in Europe. I have the Mazars independent review of our drug approval process, which commented very favourably on the expertise we have, the governance and our adherence to international standards. It did make comments on additional work that could be done on transparency and the tracking of new drug applications, but I will put this in perspective. The Cathaoirleach mentioned 60 new cancer drugs in the past three years. If we had taken a listing price from all new applications over the past five years we would have spent an additional €1 billion compared with the money that was saved. The NCPE and the CPU mark themselves against the Health Act in determining what drugs are effective, safe and appropriate and also in terms of the budgetary impact manage to make considerable savings for us.

The process is frustrating for us too because we want to see drugs getting to patients as quickly as possible. That requires the submitter, the company, to submit dossiers on time with all of the information they need and to arrive at a fair negotiated price that would allow us to spend money on other aspects of healthcare that we also need to spend money on. We want a process which gets through as quickly as possible but not at any price where we have to spend so much additional money at the listing price.

On the issue of the additional movement on screening programmes, to expand the age requires resources and not just in delivering the screening arm but also in delivering the response in clinical services for those who come through screening. That is part of where we engage in assessing the case of a screening programme. Are we able to deliver the service arm that is required, whether it is endoscopy, breast surgery or intervention in cases of dysplasia and the cervical screening programme? Does Ms Murphy wish to comment on that?