Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

I welcome the opportunity to contribute to the debate on the Health (Pricing and Supply of Medical Goods) Bill 2012, although I understand the Second Stage debate will be adjourned at 12.30 p.m. and will be resumed in a couple of weeks.

Before I get into the details of the Bill, I congratulate the Minister of State, Deputy Alex White, on his appointment.

I look forward to seeing him in the Chamber on numerous occasions when I speak about health issues. Fianna Fáil welcomes the Bill, which has been a long time in gestation. The main purpose of the Bill is to promote competition between suppliers of interchangeable medicines to ensure value for money in the supply of medicines and other prescribed health items. We spend almost €2 billion in this area each year, which is a phenomenal amount. Savings can and must be made and it is very important that this is done.

The Bill will enable patients to opt for lower cost generic medicines on a list prescribed by the Irish Medicines Board. This sounds as though an onus will be placed on the individual but it will not work this way. The Bill provides for the introduction of a system of generic substitution and reference pricing. This is a new concept and is an important part of controlling the overall medicines bill. Reference pricing involves setting a common amount for selected groups of medicines on a list approved by the Irish Medicines Board and operated by the HSE. The Irish taxpayer will only pay the reference price for a particular medicine. This is the only amount that will be reimbursed by the State to the pharmacist and the pharmaceutical industry.

If eligible patients want a branded product they are entitled to it, but they will pay over and above the reference price. In the legislation the Government is stating it will pay a certain amount for equivalent medicines but if the patient wishes to choose a branded product which costs more he or she is free to do so but must pay the excess. It is a matter of consumer choice. Some people will always be happier to pay for a brand. I do not want to trivialise it by comparing it to the fashion industry, but some people like to have a particular brand when they pay for a product. Other people are happy to know the substance of the product is the same and they are unconcerned about the brand name. It is important we get away from this because it has cost the Irish taxpayer a great deal of money. People are free to choose the branded medicine if they choose to do so. I would be happy to take the product provided for by the Irish Medicines Board and the HSE. If other people wish to pay extra that is their affair and more power to them if they want to do so. If they want to add to the profits of the pharmaceutical industry they are welcome to do so.

Unfortunately the Bill is overdue. We should have had it a long time ago. We welcome that it will make savings, but the Minister's failure to introduce it earlier this year has cost the taxpayer more than €100 million in savings which should have been achieved from 1 January this year rather than having this legislation at the tail end of the year. The spending of this €120 million will result in the HSE having to make major cuts to bring it closer to its budget because it has not achieved savings in this area.

The Bill has already gone through the Seanad. I understand this Second Stage debate will be adjourned and will not resume next week. The Dáil will not set the following week so we will not resume Second Stage until well into November. I hope the legislation will be enacted before the Christmas recess but this will be 11 months too late and will have cost an extra €120 million in profits the taxpayer has had paid to somebody in the industry. This at a cost of cutting home help and front line services.

It would be remiss of me if I did not mention some of the possible front line cuts proposed in my area. In Abbeyleix a proposal to close a hospital is still awaiting decision by the Minister. A decision is also awaited with regard to St. Brigid's hospital in Shane. These issues are up for consideration to ensure the HSE lives within its budget. The financial assumptions underlying the potential decision to close these units are fundamentally flawed. They are being considered because the Minister did not bring forward this legislation to save this money. Had he saved €120 million on this over the full calendar year we would not have to consider downgrading the respite services available in Mountrath or the adult service available in Abbeyleix. In particular I make a plea on behalf of those with disabilities and special needs that the funding of the HSE, and those contracted to do its work such as the Muiriosa foundation in my area, is maintained in the Estimates for the coming years so some of these proposed cuts will not have to be made. The way to do this is by reducing the medicines bill. Had this been done sooner I would not have to raise these topics on this occasion.

I will recount an anecdote to demonstrate what I consider to be the outrageous prices charged by the pharmaceutical and health care association. Approximately 30 years ago I wore contact lenses for a year or two. It was okay but something happened and it did not work out in the long term. I remember I had to buy solution to clean the lenses. The solution was made by Allergan, which is based in Westport, County Mayo. It used to cost £14 for a bottle which lasted approximately a month. During that time I went on holiday to Rio de Janeiro in Brazil where I saw in a pharmacy the exact same bottle, made by Allergan in Westport, being sold for the equivalent of £7, which was half the price. The Irish taxpayer was being ripped off no matter how one looks at it. The product was made in Mayo and sold in Castlebar for £14 while the same bottle made in the same factory was on sale in Brazil on the same day for £7. This shows the rip-off with regard to pharmaceutical and health care products being sold in Ireland. I do not know how they got it to Brazil and could sell it at a profit at half the price it was being sold in the pharmacy next door to the factory where it was made. It defies all logic and is one of the reasons we are having this debate. Perhaps this legislation should have been introduced 30 years ago. It is long overdue.

Perhaps over-prescribing takes place. We all know that in most houses in Ireland one will open a cabinet full of medicine. Every doctor, nurse or home care worker will tell one they have gone into many houses where a person has died and the first thing they had to do was fill up a few black bags with all of the unused medicines. This is a huge waste of taxpayer's money. These products have been paid for but not consumed. A pharmacist is not allowed re-use them because it cannot be guaranteed that they have not been interfered with and on health and safety grounds they must all be incinerated. This is too convenient, simple and lazy an approach for the HSE to take and I ask it to reconsider. The same used to be true about appliances. There was a time when hospitals did not take back crutches because they could not guarantee they were not damaged. Now a facility is available to examine crutches and if they are in good condition they can be reused. The HSE changed its position on some small appliances when it was forced to do so on economic grounds. While health and safety is the overriding feature it should be able to do the same with regard to medicines. The HSE needs to examine this important factor.

It would be strange if we did not refer to the new deal with the pharmaceutical industry which the Minister announced during the week. This is also an effort to reduce some costs. The Minister will have to explain how reference pricing will integrate with the pricing agreements in the deal announced this week. The announcement did not include details and I am sure we will hear them in due course.

The Bill is necessary. We will propose amendments on Committee Stage as we did in the Seanad. We will need to see a definition of reference pricing of drugs because if it is set too high at the outset it will be an excessive cost to the Irish taxpayer. We must look at the situation in other European countries and countries outside Europe.

Europe is one of the highest cost centres in the world. Going back to my example where the health care and pharmaceutical industry can make products in the EU and sell them cheaply in South America, maybe we should be looking at the world prices at which these products are being sold.

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