Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

It has not been ruled out - the Minister has not done so. The plan projects savings of €95 million next year in further medicine price reductions and reforms in the medicines procurement process. The plan does not, however, provide comprehensive detail of exactly how these savings would be realised. By the end of 2014, the top 20 medicines, by cost to the State, will be fully interchangeable, generic-for-branded medicines. When this occurs, further savings will become more difficult. I ask the Government to outline what specific medications will be targeted and in what way they will be targeted to ensure that further savings can be made. The Minister for Health has suggested that revised drug pricing agreements will be concluded with the representatives of the pharmaceutical industry - branded and generic - in Ireland at the start to the middle of 2015. In the past, these discussions have taken extended periods so I ask the Government to ensure these negotiations take place as a matter of urgency so savings can be made in 2015. In concluding, the Minister of State might advise when she expects them to conclude? We are told there can be savings from reform of the procurement of medicines. How exactly is this to happen?

There are some additional measures that could also be looked at. The medications known as biosimilars, designed to replace some high-tech biologic medicines, are accepted as having the same safety and efficacy as biologics.

This should be investigated as it could offer a significant saving.

Changing from a branded medication to a generic medication is not recommended for someone with certain conditions such as epilepsy who is stable or transplant patients. I have vocally supported this time and again. However, could those who are newly diagnosed with such conditions start their treatment on generic medicines and then be maintained on them in the longer term? This approach could also reduce the spend on drugs and, very importantly, offer the same level of efficacy.

The service plan fails to give much succour to those families dealing with mental health challenges. Budget 2015 laid out as a Government priority the development of community mental health services. While I welcome this aim, I note that little of substance has been provided to further it. It has been suggested more than 50% of the population suffer from some degree of mental ill health before the age of 25 years, which is a shocking statistic. This affects not only the individuals themselves but also the structures surrounding them. As in many other areas of the health system, mental health services have been grossly underfunded for many years.

Budget 2015 told us nothing that would reassure us that major change was on the way. While funding increases might be hard to attain, there are many measures the HSE could introduce that would not rely solely on increased budgets. A Vision for Change was published in 2006 and so much has changed since. If it is not to be implemented in full soon, we will need a new road map for how we progress the further development of mental health services. We certainly need an urgent assessment of mental health services, including the NGO sector, and to examine how best to integrate it. I am contacted regularly by citizens from all across the State who have difficulty in seeking the appropriate care. I suggest there is an element of a postcode lottery in this respect. Citizens should be able to rely on quality services no matter where they live.

I have said before the plan is being sold as adding an extra €625 million to the health spend next year, but of this €510 million represents the 2014 so-called overspend to be carried forward, leaving only an additional €115 million. Knowing the HSE's history, the likelihood is that much of this and more will be used to cover the cost of increased usage of the services that comes naturally with population demographics. Tacaím leis an rún. I will be supporting the motion.

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