Dara Calleary (Mayo, Fianna Fail)

As the House knows, the Minister has introduced a prescription charge of 50 cent for prescribed items dispensed to medical card holders subject to no person or family paying more than €10 per month. The prescription charge seeks to influence demand and prescribing patterns in the GMS scheme in a modest way. Prescription charges do not apply to children in the care of the HSE who have their own medical card, to the long-term illness or drugs payment scheme, to those who receive services under the Health (Amendment) Act 1996 or to methadone supplied to patients participating in the methadone treatment scheme.

Approximately 1.6 million people have medical cards. HSE data for 2008 indicate that only 2% of families with a medical card had 20 or more items per month prescribed to them. Therefore, the Minister expects that only a small minority of families with a medical card will need to pay the €10 per month maximum charge.

Prescription charges are part of a set of key actions to achieve greater value for money in pharmaceutical expenditure. These include off-patent price cuts, reductions in wholesale and retail mark-ups that have been introduced and the preparation of legislation on reference pricing and generic substitution, which is under way.

The cost of the GMS scheme, including payments to pharmacists and GPs, is projected to be more than €2 billion in 2010. The number of items dispensed to medical card holders increased between 2004 and 2009 by more than 15 million to slightly more than 50 million items. This rate of increase, an average of 12.5% each year over six years, in the cost of supplying drugs and medicines is not sustainable. Based on trends in previous years, it is expected that the prescription charges will yield €24 million in a full year or approximately €2 million per month. Every saving achieved by the HSE will reduce pressure on funding for front-line services, including hospitals, home help and home care packages and mental health and services for people with disabilities and their families. It is important in our current financial situation that we take every step possible to provide public services efficiently, limit costs to the greatest extent possible and involve the users of resources in understanding better the value of those resources and their appropriate use. The Minister has committed to keeping the implementation and impact of the charges under constant review. I will refer the Deputy's specific concerns regarding psychiatric patients to her for a direct response.

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