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

I welcome this motion which arises out of revelations of gross misconduct by a leading pharmacy chain. Lloyds, the State’s biggest pharmacy chain, significantly boosted its dispensing fee income by claiming multiple payments from the State for single prescriptions presented by medical card holders. In recent weeks, the pharmacy made a €12 million repayment to the HSE in settlement of a year-long dispute over fees. This malpractice was uncovered last year following media investigation.

I commend those who brought this situation to light but I also find it extremely worrying that the HSE was clueless to such misconduct. This is not a unique case as I understand that a string of other pharmacies are under investigation for allegedly over-claiming dispensing fees. This motion rightly raises concerns about the HSE's monitoring systems. It goes without saying that in instances where taxpayers money is at stake the monitoring system should be watertight. In this instance, the €12 million repaid to the HSE has the potential to make a significant difference, if spent wisely, in a health service that is severely under-resourced. If other pharmacies are found to be operating in a similar fashion, there is a considerable sum of money owed that has the potential to improve the health system, given every euro counts.

The HSE claims the practice constituted fraud. I believe, therefore, that it is reasonable to ask of the HSE how those accountable will be held responsible, if at all.

What system will they put in place to ensure that such fraudulent practices do not happen again?

I also draw the Minister's attention to the amendment tabled by my party, and I note his earlier remarks. I ask all Deputies to vote in favour of it. I commend it to my colleagues in Fianna Fáil, who tabled the substantive motion this evening. The amendment calls for the reclassification of those prescription-only medicines identified by the Health Products Regulatory Authority as suitable for over-the-counter in-pharmacy status, and I call on the Minister for Health to introduce legislation to oblige pharmacies to inform patients of a pharmacist's dispensing fees, pharmacy services and mark-ups through in-store displays, so that pharmacists would be required to use a standard, clearly visible template and provide the patient or the patient's representative with an itemised receipt following the dispensing of medicines.

I want to use a little of my time to appeal openly and publicly to the HSE and its primary care reimbursement service, PCRS, to approve the use and funding of nabilone for chronic pain management and relief. I use this opportunity to ask the Minister to take note of this very important area. Nabilone is a man-made form of cannabis used to treat severe nausea and vomiting brought about by cancer chemotherapy. It is also a recognised treatment for non-cancer pain. In a 2011 review of nabilone's effectiveness and safety, it was demonstrated that the drug "significantly reduces severity of pain in patients with chronic non-cancer pain", including spinal pain. In February 2016, while we were battling it out in the general election, an article published in Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapynoted that while nabilone is now approved in many countries, including but not limited to Canada, the United States, Mexico and Britain, for the treatment of severe nausea and vomiting associated with chemotherapy, more and more clinical evidence is emerging for its use in managing pain conditions with different etiologies.

I raise this issue because I am at my wits' end as a Dáil Deputy and a spokesperson on health for 14 years. I cannot make any progress on behalf of a constituent, who is at his wits' end in a whole different place to me. In this man's situation, nabilone can be the only life saver, and I do not say this lightly. I appeal to the Minister to intervene and to help secure funding approval for the use of nabilone in the chronic pain management and relief for this man and any others in a similar situation. I have been in touch with the PCRS and we have exchanged correspondence. I have spoken directly and made every appeal imaginable, as have the local pharmacists, the Minister's colleague's counterparts in my home town. They have made repeated efforts to impress the importance of this drug's approval in this particular man's case. An exceptionally small number of people are involved, so while it is an expensive drug comparatively, nevertheless it is not a prohibitively expensive drug. I appeal to the Minister to note the situation regarding nabilone, and I ask him to please come back to me, if he would be so gracious, about this matter at his earliest opportunity.

To reiterate my earlier point, my party welcomes the motion and will vote in favour of it, preferably, if Deputy Calleary will note, with our amendment accepted. We believe it would enhance and strengthen the proposition. I have not used all of my time and I thank Deputy Louise O'Reilly for giving me a little extra.

See this speech in context