Dáil debates
Tuesday, 12 November 2013
Topical Issue Debate
Prescription Charges
6:40 pm
Ciara Conway (Waterford, Labour)
Link to this: Individually | In context | Oireachtas source
The second global conference on family planning was held in London last year, involving not just politicians and advocates but also philanthropic organisations. Some €2.6 billion was committed to the area of family planning, while the G8 and developing countries set goals and targets. Today in Addis Ababa, the third global conference on family planning commenced with the focus on reducing teen pregnancy and facilitating access to contraception. Nobody would argue with the idea of reducing teen pregnancies and ensuring that young women have access to contraception. With this in mind, I have tabled this Topical Issue matter.
Women can only get a three-month or six-month prescription for the contraceptive pill. This means that women will be required to bear the cost of their gender and will have to pay a prescription charge just to look after and take control of their own bodies. Last week, the Irish Medical Organisation reported that the contraceptive pill Ovranette costs 71 cent. Therefore, the prescription charge of €2.50 will be substantially more than the price of the drug. The charge far exceeds the price the State pays for that contraceptive pill. In previous parliamentary questions I have submitted to the Minister for Finance, I pointed out that oral contraceptives are subject to a 0% VAT rate. However, all non-oral contraceptives are still subject to a 13.5% VAT rate. This puts more effective methods of contraception beyond the reach of some women. I understand that the imposition of a 13.5% VAT rate on non-oral contraceptives is due to EU regulations. In the coming months I hope to work on this matter with my EU colleagues because it must be changed.
I ask the Minister to apply exclusion criteria, similar to those in the UK, whereby prescriptions for contraceptive pills would be exempt from the charge.
I have tabled a series of parliamentary questions, in respect of which I await a reply, on the proposed publication of the Government's sexual health strategy. I hope this strategy will advocate and propose the inclusion of the universal provision of free contraception.
In an age where cash is king and where Governments, and rightly so, want to ensure effective use of public moneys, I ask that the Government commission the undertaking of a study of the most cost-effective way of providing universal free contraception and universal sexually transmitted infection, STI, screening based, perhaps, on the cervical check model, which provides free sexual health care and STI screening to all female residents in Ireland. I believe the contraceptive pill should be exempted from the €2.50 prescription charge because, as I have outlined, the actual cost of the pill to the State is far less than that. I believe that this is an unfair charge levied on women because of their gender. I await the Minister of State's response.
6:50 pm
Alex White (Dublin South, Labour)
Link to this: Individually | In context | Oireachtas source
The Health (Amendment) (No 2) Act 2010 provides that a person who is supplied with a drug, medicine or medical or surgical appliance on the prescription of a registered medical practitioner, registered dentist or registered nurse prescriber shall be charged a prescription charge per item, subject to a limit per family per month and that this charge will be recouped from payment to the pharmacist.
Since 1 January 2013, the charge per item is €1.50, subject to a maximum amount payable by a person and his or her dependants of €19.50 in any one month. Prescription charges are part of a set of reforms introduced by Government in recent years to reduce pharmaceutical prices and expenditure. These include reductions in drug prices, reductions in fees paid to pharmacists under the FEMPI legislation and the introduction of generic substitution and reference pricing.
As announced in budget 2014, it has become necessary to increase the prescription charge due to the very difficult and challenging economic environment which requires the Government to achieve additional savings in health expenditure, with €666 million in savings targeted in 2014. The increase in prescription charges will account for €43 million of this target. The Government is committed to achieving these savings while protecting front-line services to the most vulnerable to the greatest extent possible. Medical card holders will be required to pay a €2.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €25 per month for each person or family. These new rates will be effective from 1 December 2013.
For the purposes of applying the charge, a spouse or a cohabiting partner, children under 16 and children aged over 16 and under 21 who are in full-time education and wholly or mainly maintained by another adult person who has full eligibility will constitute a family for the purposes of applying the charges. There are a limited number of exemptions from prescription charges. First, children who are in the care of the Health Service Executive under the Child Care Acts 1991 to 2007 are exempt. All other GMS clients will be subject to prescription charges. Second, the supply of methadone to opiate dependent clients is exempt. Methadone clients will be required to pay the charge on prescription items other than methadone. The supply of methadone for non-opiate dependent clients is not exempted. Third, as the supply of high tech medicines operates on the basis of a patient care fee, a prescription charge will not apply.
The legislation does not provide for an exemption from the prescription charges for any particular category of drugs, medicines or medical and surgical appliance. The three areas of exemption to which I referred are referable to particular categories of individuals rather than to drugs, medicines or medical or surgical appliances. There are no plans to provide for this category of exemption.
Ciara Conway (Waterford, Labour)
Link to this: Individually | In context | Oireachtas source
I thank the Minister of State for his response which gives me some hope. As the Minister of State rightly pointed out, the exemptions do not apply to any particular drug but to a particular cohort of people. The people who are most likely to be taking the contraceptive pill are women, who are a distinguished group in society. There is scope if the willingness exists to provide this exemption. It is unfair that women because of their gender must pay this charge. As indicated in the Minister of State's response, the exemptions to which he referred relate not to a particular drug, but to a particular cohort of people.
I believe this is something we should do. We know that when women can provide space and time between each of their children, the outcomes for those children, women and households are better. This is something with which we should be able to help and support women. We know that having effective family planning in a progressive society leads to good outcomes for children and women. In my humble opinion, it also makes them more productive and effective members of society. I believe there is scope to apply an exemption in respect of the contraceptive pill.
Alex White (Dublin South, Labour)
Link to this: Individually | In context | Oireachtas source
I am not sure I can add a huge amount more to what I have already said, namely, that the scheme of the rules comprehends exemptions for specific individuals or categories of individuals. I understand what the Deputy is saying, including the argument made in her rejoinder. However, this would ultimately amount to an exemption with respect to a particular type of medicine or drug, which is not provided for under current rules. Even if the exemption were to be extended to a category-gender, this would still mean an exemption with regard to, presumably, contraception and not all prescription items. We have a difficulty in terms of how the current rules are applied.
I thank the Deputy for raising the issue and note the compelling points made by her in terms of the importance of the sexual health strategy being brought forward in the context of screening and, in particular, sexual health issues, which issues the Deputy has previously drawn to the attention of the House. I agree with her that they are important priorities.