Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I move amendment No. 10:

In page 21, between lines 18 and 19, to insert the following:“12.--(1) The prescriber shall detail the purpose of each medicine on the patient's prescription.

(2) The pharmacist shall include the purpose of each medicine on the label when dispensing the medicine.”.

This amendment arises from the discussions on Committee Stage. On foot of those discussions, I tabled this amendment which states that the prescriber, who is the doctor, shall detail the purpose of each medicine on the patient's prescription, and the pharmacist shall include the purpose of each medicine on the label when dispensing the medicine to the patient. It comes back to the point I made when discussing the last amendment, as well as on Committee Stage, which is that there is an issue of familiarity with regard to the medications people are prescribed. They may only know it is, say, a pink tablet of a particular name that they have been taking for their heart condition for perhaps five or six years. It is important that we not only look at the issue of trying to save money through generic prescribing but also that we try to save money in regard to compliance by patients with the instructions for a particular medicine, for example, that they take it at the proper time. In order for them to do that, however, they need to know what the medicine is for. It would improve compliance if people knew exactly what their medicine is for, and this would also ensure that if there is a mistake on the prescription, the person will see this very quickly.

I know the Minister of State will say the pharmacist has to explain to the person that this is a replacement for a previous medicine they had, and that everything will be hunky-dory as a result. As we know, the biggest current problem with medicines is in regard to people complying with the instructions for taking them. If we could improve that, people would not have to be admitted to hospital on as frequent a basis. There is also a huge potential saving in the long term for the Exchequer if we could have a greater level of compliance in regard to medicines, and one way of ensuring this is if people know exactly why they are taking the medicine.

The Bill will add to the confusion. I know the pharmacist will explain to the patient, or the person picking up the prescription for them, what is the purpose of this measure. However, in many cases concerning compliance issues, we are dealing with older people who may get confused due to having to take a whole series of medicines. They will ask what the pharmacist has told them to do and wonder whether they should take the medicine at a certain time, even though this may be written on the label. It is not the case that we are dealing with just one medicine in isolation. It is not uncommon for people to be taking 15 or 20 different tablets a day for different medical conditions. I will use the example of an older person, Mrs. Murphy, who has been taking a particular branded product for her heart condition for six years. Following the introduction of this legislation, she will be told by the pharmacist when she goes to pick up her medicine that there is a cheaper substitute and that, while she can continue to get her branded product, she will have to pay the difference, or she can have the cheaper alternative. If she also uses a cholesterol medicine or coagulant, the option to use a cheaper generic alternative will be given to her. Older people will have to try to remember what each medicine is for and remember exactly what the pharmacist told them about each one. In practical terms, that is what is going to happen on the ground.

What I propose in this amendment is that the GP would write out the purpose of the medicine, whether it is for a heart condition, cholesterol or otherwise, and the pharmacist would ensure this is put on the adhesive label on the outside of the receptacle containing the medicine. This would deal immediately with the confusion that can be caused by the substitution of medicines but also, more important, it would have an impact in regard to compliance with the taking of medicines, which would be an added benefit. In addition, it would also help in regard to the issues raised on the previous set of amendments in terms of consistency. It would help to identify where mistakes are made because patients can identify whether they have, for example, received their heart condition medicines correctly, or, alternatively, that they had received cholesterol medication when they do not have a problem with cholesterol. There would also be a benefit in that people may be taking medicines unnecessarily because they have always been prescribed it by their GP but do not actually need it.

There are potential savings to be made, as well as dealing with compliance issues and addressing the issue of familiarity that people have with a particular medicine. We must address some of the confusion that will be caused due to the introduction of this legislation, even taking into account the checks and the safety net the Minister has included in the legislation. We have to remember we are talking about people, many of them older people who get confused easily and who are dealing not just with one or two medications but with many. The amendment would help in achieving the purpose of the legislation. The Minister of State agreed with the principle of my point on Committee Stage and I hope he can now accept the amendment.

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