Ruairí Ó Murchú (Louth, Sinn Fein)

I would like to take this opportunity to follow up on Deputy Crowe's point. Many of us attended that briefing in the audiovisual room on those suffering from Duchenne muscular dystrophy. As Deputy Crowe said, we are talking about it impacting children and young boys at a very early stage. He made the most significant point of all, which is that there is very little time, as all these families know. In one case, we met with a family who had two boys, one of whom gets the givinostat, because he was on a previous pilot, but the other does not. They are absolutely fearful of the impact of not having it because they have seen the benefit of having it. Deputy Crowe put forward a possible cross-Border solution, a shared island solution, or call it what you will. I ask the Minister of State to bring that back to his colleagues in government. It is absolutely necessary. I do not think he will find too many people complaining about delivering on that.

I commend Deputies O'Rourke, Cullinane and Crowe on the Healthcare (Transparent Payments) Bill. I would much prefer if this was progressing beyond this point. If there are anomalies or issues that needed to be dealt, they can be dealt with on Committee Stage. The Minister of State, Deputy O'Donnell, provided a comprehensive solution.

I accept the argument is won with regard to the necessity of this legislation. What are we talking about? We are talking about making it mandatory for pharmaceutical companies and medical equipment suppliers to declare payments, gifts, donations and all other transfers of value made by them to healthcare professionals and organisations. We have research carried out by the Royal College of Surgeons in Ireland, RCSI, and James Larkin. A fair number of us have seen "Dopesick", have read Empire of Pain and have seen what happened with the Sackler family and the Purdue company and OxyContin. To call it a disgrace is inadequate; there is no term for what was done other than it was utter and outright evil. The reality is when payments were made, it made it a hell of a lot easier for them to sell their drug. The biggest issue of all was the fact that it was based on a complete and utter lie, which was the idea that they had found this pain relief mechanism - this opioid - that would be slowly released and work absolutely perfectly and there would be no issues as regards addiction. We know the time release was dealt with very quickly. People just had to lick the particular tablet to get around it. Following accidents or whatever, people who never would have found themselves in this situation ended up with brutal addictions and when they could not access OxyContin, they ended up on street drugs such as heroin and other drugs. It ravaged many communities in America. There was the whole scenario then of people who followed up with pill mills and all the rest of it.

We are aware of the issue we have with prescribed drugs and narcotics in this State. We need to make sure we are playing on a level playing field and have a system that works. The biggest problem is the lack of transparency regarding these payments at this point. We are talking about a huge number of conflicts of interest.

There are consequences for patients but also for public finances. I spoke earlier about the fact that there are certain life-altering, life-changing, life-improving and life-saving drugs at which we need to look. I accept that at times it can be expensive, but we definitely do not need to be losing money while others are getting rich. As I said, we need to ensure transparency and that we do not certain allow scenarios. It was not just one dirty deal, as happened in the situation we spoke about with Purdue, it was a million dirty deals. The impact has been phenomenal. It is an impact that will continue long after this period of time.

We know the current voluntary system is absolutely inadequate. We need a centralised State-run mandatory disclosure system. Obviously, this would enhance the HSE as regards trust and integrity. It would be a fair and competitive innovation environment and it would support Ireland's clinical trials landscape, which is absolutely necessary. At times we come in here to request additional finance for additional services and medicines, but we could be talking about cost savings here. I get it that the argument is won in this regard.

I agree with Deputy Crowe that this should have happened a hell of a lot sooner. A fair question is around why it has taken so long. As I said, I do not buy the idea that it will take a year, but within that year, we need to make sure this is ready to run. There can be no hold-up in this regard. Nobody is going to come in here and vote against this or make an argument against this. This is about improving human health and ensuring people are looked after properly and that everything is absolutely above board.

My colleagues spoke about the declarations to the HPRA, if there is a need, and that if there were breaches, there would be a means of enforcement. We mentioned fines of €100,000. However, we are all open to changes in that regard. When we have breaches, we need to ensure we provide real enforcement, real leverage and real power. We all accept that we cannot leave big pharma or uncontrolled capital to have its way. This is about protecting people and patients and ensuring we look after our people and the public finances.

I commend everyone who spoke today and, in particular, Deputies O'Rourke, Cullinane and Seán Crowe for making it happen and following up on a huge body of work done by the RCSI. We need it to happen. It is as simple as that.

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