Mr. Bernard Gloster:

As the Deputy knows, the current system within the HSE is that drug companies make an application to us for the application of a drug for reimbursement for a particular illness or illnesses. It goes through a health technology assessment and then goes through a pharmacoeconomic assessment and is then negotiated at a price. That is the best we can do in the public interest. We have done that faithfully. We have done it very well. In the three years I have been in this job, we have increased the number of drugs every year that have been brought on to reimbursement. The process has been evaluated and commented on as a very robust and transparent process. We have exceptional measures processes for people who might fall outside of that. For example, if a drug is approved for reimbursement for 25-year-olds, there can be an exception for people above 25 years of age and I had a case like that last week. There is a very rapid process for dealing with that.

I am very conscious there are wider agreements going on with both the pharma sector and the pharmacy union so I do not know if the Secretary General wants to comment on the early access issue. I am not in a position to go any further than that at the moment anyway.