Pádraig O'Sullivan (Cork North-Central, Fianna Fail)

It will not come as a surprise to the Tánaiste that I am going to use this question to again raise the issue of the rare disease drug reimbursement process we have. I have lost count of the number of times I have been in here with the Tánaiste and the Taoiseach over the last five or six years since I became a TD. I can quote league tables until the cows come home showing how we languish as laggards in a European context. The most recent report ranks us 28th out of 36 European countries with regard to providing drugs, for example, for patients who suffer from a rare condition.

I am not going to waste my time on that today. I would like to focus on what the programme for Government is going to allow for us going forward. There are two specific references in the programme for Government that give me some bit of hope and optimism for the future and I would like the Tánaiste to provide some clarity on that. First, there is a provision in the programme for Government on the devising of an early access scheme. I met with the Minister for Health in the last weeks and, to be fair, since she was appointed she has been very proactive.

I must give her credit for that. Specifically in respect of early access schemes as a focus in the programme for Government, I need to emphasise how important it is that any early access scheme needs to be decoupled from the existing reimbursement process. If we are going to put drugs through a process that essentially has to run through the same hoops as the system that is currently in place, it will be doomed to failure. That is my concern. Typically you are looking at 600, 700 or 800 days for reimbursement for a rare drug. As I said, any system that provides for early access will have to radically overhaul that.

The second point in the programme for Government is a commitment to a review of the reimbursement system as a whole. Again, that is something I have sought for a number of years. Any review we undertake cannot be a carbon copy of the Mazars report. The Mazars report, from inception to its actual publication, took the best part of four or five years. We have committed to this in the programme for Government as a provision. We need to actually start the process of reviewing the current reimbursement system now. If we wait a further two years, we are not going to see the full published review by the end of this Government's term.

Today I ask for two things. Will the Tánaiste give me the direction of any thinking in respect of an early access scheme? How quickly can that come on stream? With regard to the overall review of the reimbursement system, will the Tánaiste give a commitment that it will start urgently so that we can at least have it published in the next couple of years?

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