Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I thank the Minister for making the effort to be here this evening and for his contribution. I also thank the Minister of State, Deputy Catherine Byrne, Deputy Louise O'Reilly from Sinn Féin and my party colleague, Deputy John Brassil, for their contributions to this discussion.

It is important to point out that when we bring forward legislation, we do so in the interests of the public good. This debate has focused on the issue of how clinicians, medical practitioners and prescribers interact with the broader industry. There is absolutely nothing wrong with that. It is a good and healthy situation that we have a critical mass of pharmaceutical and medical devices companies in this country which interact with universities, colleges and hospitals in the context of research and development. That has brought about a transformation in both medical technologies and medicines. If one takes the research conducted across the globe in recent years into cancer, we can now treat some cancers that were untreatable only a few years ago. The same is true of treatments for HIV, hepatitis and so forth. Profound changes have been brought about by pharmaceutical companies interacting with colleges and research institutes across the globe. Such interactions have resulted in the development of transformative medicines that can change and save lives. It is a positive thing and all we are asking for is transparency to ensure that nobody could have suspicions or undermine the credibility of the research and innovation that is taking place across the globe. Obviously, in the Irish context, we can only address it legislatively here.

This Bill was prompted by clinicians who approached me, asked me to raise this particular issue, sponsor legislation and bring it to the floor of the Dáil. They wanted to get the debate going and I thank the Minister for his contribution to that debate. If we could shepherd this Bill through the legislative process by commencing the pre-legislative scrutiny process and using the resources and knowledge within the Department as well as in the Attorney General's office to improve the Bill, I would be delighted and will be happy to assist in any way.

As I said earlier, philanthropy is a good thing. Just because a company is sponsoring a nurse or doctor does not mean that there is anything untoward happening. However, it should be up-front and declared. To move away from the legislation slightly, I wish to refer to the advances that have been made in medical technologies and medicines and the great challenges facing the State in the coming years in terms of funding those medicines. In that context, we will have to broaden our discussion of how we assess and fund new medicines and medical technologies. While the National Centre for Pharmacoeconomics, NCP, under Dr. Barry does its job, we need to look at the assessment of drugs for rare diseases. Other countries seem to use a different system of assessment and funding and there is a European dimension to this that we must begin to embrace. I know that the Minister is examining that concept but we must be more proactive in how we embrace advanced, innovative medicines and in terms of how we assess and reimburse them. That is an area where we are beginning to drift. That is not a criticism but an observation.

I know the State has limited resources. Decisions on reimbursement are made by the NCP which has its own guidelines. Reference must also be made to the HSE's corporate pharmaceuticals unit which enters into negotiations with pharmaceutical companies and may or may not reimburse. Then we have advocacy groups who literally have to come to the gates of this Dáil to try to prise the system open to allow certain drugs to be reimbursed. We have to be more open in how we conduct that assessment process. We need meaningful assessments that can be viewed in an open way. I will always accept that there are commercial sensitivities involved but it seems that other countries can do this in a more meaningful way that allows them to deliver drugs to patients in a more timely manner. If countries which have a smaller GDPper capitathan ours can fund these drugs, why can we not do so? We are cutting edge in many areas but in recent years we have slipped back to a certain extent in embracing new, modern, innovative technologies and drugs. It is an issue for another day but it relates to this legislation. We need to have openness and transparency in the context of clinicians, prescribers and those who are recommending medicines in our health system. Equally, we must have openness on the other side in terms of how we assess and determine what drugs are reimbursed and made available in the health system.

I thank the Minister for his remarks on the Bill. I have already referred to the reasons for bringing the legislation forward, some of which would certainly cause concern. As I said, however, I do not want to suggest that any clinician has engaged in untoward activity. I simply want to bring openness to the area and some of the professional bodies have also recommended that something be done on this issue. If the Minister could help us to move this Bill through the legislative process, that would be a good day's work not only for the State and the public purse, but also for the integrity and credibility of our clinicians, the research they undertake, the clinical trials in which they are involved and the prescribing patterns in our health service.

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