Mary Harney (Dublin Mid West, Independent)

With regard to Deputy Ó Caoláin's comments, I did not say I would reduce the charge to zero but the Minister has the capacity to do so. In other words, an amendment is not needed to reduce it to zero, as that is provided for in the legislation. I do not want to mislead anybody and I did not suggest the charge will suddenly be zero in a few months. However, we need to establish how the provision performs over a period of 12 to 18 months.

I very much share the views put forward by Deputy O'Sullivan regarding lifestyle and so on. It challenges us all to lead healthier lives and to take exercise. Professor Drumm made a presentation earlier to the Cabinet sub-committee on health and I must ask him to make it available to the Oireachtas Joint Committee on Health and Children. He referred to Dr. Thomas Allinson who is better known for his bakery than for practising medicine. He was a GP in the UK who was struck off in 1893 for recommending that smoking was bad because, apparently, at the time smoking was regarded as good for one's lungs. He recommended that people should exercise three hours a day, eat fruit and vegetables at least once a day, cut down on salt, not work too hard, avoid tea and coffee before bed and be teetotal. He asked people to stop smoking and he was brought before the medical council. He was struck off and then he opened a bakery. He wrote letters to the British newspapers advocating his recommendations. It is amazing how much has changed in the intervening years but, as we move forward, all these issues have to be reviewed.

The reason generic products are more expensive is the pharmaceutical industry, on foot of a request of mine earlier this year, reduced the cost of off-patent drugs by 39% and that reduced their price to below that of many generic drugs. We were unable to get that agreement from the generic manufacturers but their contract is up for renewal in September and we expect to get substantial savings. In any event we will have the legislation for reference pricing and generic substitution later this year, under which the State will set the price it will pay. If individuals want the branded product, they will pay the difference and pharmacists will have the capacity to substitute.

I am a strong fan of drug reviews. We currently have a pilot project in operation with a number of pharmacies and patients. I am not sure how many pharmacies are involved but it is being conducted during the months of June, July and August. We will have the data in the autumn. It will examine the medication across the approximately 100 patients who are part of the review. We are working with the community pharmacy sector on it. The intention is to use pharmacies and the skills of the pharmacists, as professionals in the health care sector, to a greater extent. As I mentioned previously, we had a good meeting recently with Dr. Barry White who is leading for the HSE on quality clinical care. He has a number of leading clinicians developing care pathways and I believe pharmacy has an important role to play in that.

I am conscious of the fact that we do not have additional money. We have effectively taken €1 billion out of the public health services and reduced the staff over the last four years by 4,000 but the number of procedures and treatments has greatly increased. That is a fact. We are trying to drive value and get more for less. The HSE's procurement is now probably the best that is operating in the public sector in terms of the value it has been able to drive. That is one of the big advantages of having a single entity - one has more muscle when procuring goods and services. That muscle is delivering more for less, be it in terms of legal or other services. We must continue to do that because next year will be a challenging year as well.

Deputy Reilly mentioned the Minister for Finance. The Minister for Finance is always involved with regulations that involve money, across all Departments. He is responsible for the public finances, so raising money or reducing one's charges must involve the authority of the Minister for Finance as well as the line Minister, in this case the Minister for Health and Children.

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