Michael Harty (Clare, Independent) | Oireachtas source

I will also support the Bill as it is the start of progress. Reducing the prescription charge from €2.50 to €2 for those aged over 70 years and capping it at €20 per month is a start, although a very small start. When this prescription charge was introduced in 2010, it was 50 cent and it was meant to reduce unnecessary taking of drugs where people were getting drugs under a medical card and not using them. The 50 cent charge was a disincentive to asking a pharmacist for drugs. However, as time passed, the charge went from 50 cent to €2.50. If memory serves correctly, the Fine Gael Party campaign in the 2011 general election said the party would abolish the prescription charge but when the now Senator James Reilly came into ministerial office, he increased it incrementally, year on year, until it reached the level of €2.50 per item. That is a substantial burden on patients where it was not that people were getting unnecessary medication, but they stopped getting necessary medication. That had untold consequences for the health service as people not taking their medication ended up in hospital. Although it was set up as a deterrent, it ended up being a method of revenue collection, which amounted to a negative health policy.

It is good that this is being reversed and, as the Minister notes, it will apply first to those who use medication most, those over 70 years old. The €2.50 charge is substantial for any patient on a medical card, which they have because they have been means tested. This is not a wealthy cohort of society but these people are being charged €2.50 for each item. There are people under 70 years who are not getting their medication because of the charge for prescriptions.

The Minister referenced generic drugs and the savings they bring to the health service. There is a caveat in that generic drugs may have equal bioavailability but they do not have equal constituents. Many patients suffer side effects from generic drugs and 10% of hospital admissions are related to iatrogenic illness, meaning it is caused by side effects of drugs.

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It has increased since generic drugs were introduced. They are not equivalent and many people suffer side effects. One patient of mine went through investigations for nine months before it was eventually discovered that the medication he had been prescribed, in a generic manner, on discharge from hospital was not the same medication as he received when he entered hospital. He had a substantial illness because of it. I could cite many other cases.

I commend the Minister for introducing the domiciliary care allowance measure. It is a very progressive provision. However, as Deputy Billy Kelleher said, these are people who should have had a medical card long before now. When I worked as a GP, it never ceased to amaze me when I wrote prescriptions for people with substantial disabilities and they told me they had no medical cards. It was unbelievable. Although it is late, it is very welcome.

Disabilities put substantial pressure on patients, children and their families. There is a substantial unmet need among people with disabilities. This will address some of it. There is financial stress involved in looking after a person with disabilities. Access to aids and appliances was a huge barrier for people with disabilities. Not only could they not get drugs, they could not get the aids and appliances they needed to help them cope with their disabilities. Disability is a long term condition; it does not come and go. Obliging patients to go under constant review to retain their medical cards up to now was unjust.

The Minister's policy on medical cards must also be reviewed. We have discussed it at length at the Oireachtas Committee on the Future of Healthcare, where we are trying to devise a system which is fair, equitable and based on need rather than the ability to pay. We must address all these issues regarding medical cards. Discretionary medical cards are also a major issue as is the granting of medical cards to patients who have cancer. One has to be terminally ill with cancer in order to get a medical card, and that is very unjust.

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