Kate O'Connell (Dublin Bay South, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the witnesses. It is nice to see Mr. Breslin again. I want to take up a few issues regarding the reality of the situation. Deputy O'Reilly mentioned the anecdotal evidence. My understanding is that people on the ground, and older people in particular, are stockpiling drugs, especially drugs with narrow therapeutic indexes and so on. In the event that a GP has run off a six-month GMS prescription form and it is legally presented to a pharmacy which has stock on the shelf, Mr. Breslin will understand the conundrum of a pharmacist who is faced with a person who is concerned about the future. Perhaps the person gets his or her news from Sky rather than the BBC or something else might feed his or her fears. My understanding is that people on the ground are stockpiling and I am concerned about that. I am sorry for being late, but I have heard various reports that we have approximately ten to 12 weeks of headroom in the supply chain for medication. If people are getting six months' worth of prescriptions, that headroom will be depleted.

Often when a product is in short supply or is controlled, there is a limit to the number of packs a retail pharmacy can acquire in a month. I assume somebody puts something into a computer and once a business has its 20 packs, it gets no more. Has the Department imposed or considered imposing anything like that? Has it considered limiting the monthly orders of retail pharmacies dealing with one of the big suppliers to 1.2 or 1.1 times what they ordered in the previous month?

There has been talk of a media campaign. I urge caution in that regard because when one tells people not to stockpile, the first thing they do is get a truck and fill it full of tablets. That is the nature of people and the survival instinct. When it comes to supply issues, some of the products we get in through the UK include bespoke feed bags, total parenteral nutrition, TPN, and specials. In this committee and within my own party I have heard conversations about how the Department has engaged with the manufacturers. My understanding is that approximately 80% of some types of TPN comes from one place in the UK. Are we sure that, if there is no deal and the UK crashes out on 29 March, we will be able to feed those people in April? Do we have the capacity to supply ourselves as a stop-gap? Does the Department have something in place so that somebody waiting for their nutrition in one of our acute hospitals will not be left hungry?

Regarding the marketing authorisations and dual labelling arrangements we have with the UK - and Dr. Nolan might be the expert on this - my understanding is that we have piggybacked on the UK for a long time in respect of packaging. Most marketing authorisations are authorised through the UK where the qualified person, QP, is domiciled in the UK. If there is a hard Brexit and the UK is not in the EU any more, the QPs who are authorising medications and who are responsible for pharmacovigilance will no longer be allowed to sign off because they will not be domiciled within the EU. This leads to a conundrum where we speak English and nobody else does. Are there provisions in this regard in the event of a no-deal Brexit? Have we spoken to the Dutch or other friendly countries which might print the other side of their information leaflets in English? Is there something in place to deal with the fact that we are piggybacking on the QPs in the UK, which may no longer be possible?

As a UK graduate, I am interested in professional qualifications. The witnesses have said there will be an additional layer, but that assumes that the standards will stay the same. With respect, that is only a short-term solution. With regard to people who have graduated recently, it is unlikely that the UK will have allowed standards to fall too far by summer, but theoretically we can only add in that layer if there is alignment of standards. Is there any plan for what happens thereafter? I know we are talking about things that could happen based on whatever happens across the water.