Dáil debates

Tuesday, 11 July 2017

Other Questions

Defence Forces Medicinal Products

5:50 pm

Photo of Clare DalyClare Daly (Dublin Fingal, Independent)
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47. To ask the Taoiseach and Minister for Defence further to Question No. 262 of 30 March 2017 and the clarification of 13 June 2017 (details supplied), the year in which the Defence Forces was first of the view that the specific reactions of anxiety, restlessness or confusion, if declared by a member of the Defence Forces to be present, would necessitate withdrawal of mefloquine. [32348/17]

Photo of Clare DalyClare Daly (Dublin Fingal, Independent)
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This follows a previous question that was answered thanks to the good offices of the Ceann Comhairle, about listed side effects of Lariam. We asked the Minister of State to say whether they were deemed minor, tolerable or intolerable. This is important because that is the basis upon which the Defence Forces define whether someone can serve or not, and whether Lariam should be withdrawn.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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The State Claims Agency is currently managing 55 claims which have been made by members and former members of the Defence Forces who allege personal injury as a result of their consumption of mefloquine, also known as Lariam. The first was scheduled to be heard in the High Court on 4 July 2017 and has now been adjourned to 3 November 2017. The question raised by the Deputy would engage me on matters that relate to the litigation. It is therefore inappropriate for me to comment on the matter.

6:00 pm

Photo of Clare DalyClare Daly (Dublin Fingal, Independent)
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It is interesting that it took an inordinate length of time to get the Minister of State to provide some clarity on the matter prior to the case being listed before the High Court. In any event, the position of the Defence Forces on the matter has been that if someone is going to sub-Saharan Africa, he or she must be given the drug at least two weeks prior to departure to accommodate either minor or tolerable side effects or to determine whether the side effects are intolerable. The problem has been that the Defence Forces have never defined what was tolerable and minor and what was intolerable until, with the intervention of the Ceann Comhairle, the Minister of State answered a previous parliamentary question admitting, and there is no secret about this, there were adverse reactions which mandated that Lariam would be discontinued. My question today sets out a list of specific reactions, including anxiety, restlessness or confusion, which terms were used as early as 1995 in the newsletter of the Irish Medicines Board, as well as by the manufacturer of the drug in its list of side effects. When did the Defence Forces become aware that the side effects required the discontinuance of Lariam? The Minister of State has already admitted to me that there were other side effects that were deemed to be intolerable and which required the discontinuance of Lariam.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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The choice of medication is a matter for the medical professionals within the Defence Forces, namely, the medical officers. It is not up to Members of Dáil Éireann to decide on what is the most appropriate medication to be taken in sub-Saharan Africa. All personnel are screened prior to deployment to ensure they are suitably fit for whatever medication is prescribed. It is the medical professionals who assess each individual. I expect that the report of the review group will be given to me shortly. At that juncture, I will consider the findings of the review group and whatever recommendations are made in the report. Due to High Court litigation which has been adjourned from 4 July to 3 November 2017, I am precluded from commenting any further on the individual cases.

Photo of Clare DalyClare Daly (Dublin Fingal, Independent)
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The decision is, of course, a medical one, but it is a decision based on medical advice which the Defence Forces themselves take. As such, it is not a theoretical, abstract or political question. It is a factual medical situation. The Minister of State has stated in previous correspondence that there is a list of adverse reactions that would mandate the discontinuance of Lariam. I ask the Minister of State when the Defence Forces were first of the view that the specific listed side effects would necessitate the withdrawal of Lariam. The answer is a date or a year. The reason for this is that if someone presents with side effects which are deemed to be intolerable, he or she is told that Lariam will be discontinued and he or she will no longer be allowed to serve in places like sub-Saharan Africa. This is an area that has not been adequately or publicly defined previously. It is a simple matter or providing a date and time answer. That is not impacted on by litigation or anything like it. It is obviously based on medical knowledge.

Photo of Aengus Ó SnodaighAengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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This is not a question on the administration of Lariam per se. The Minister of State made a comment that it was not up to the Dáil to make a decision on medical advice and the administration of Lariam. Given that the Cabinet regularly issues funding based on HSE advice on medicines, it is a political issue as to whether the Dáil takes a decision which is not complied with by Cabinet or the military authorities. The Minister of State was wrong in what he said, unless he elaborates further on it.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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It would be totally inappropriate for me to comment on the decision-making of the medical professionals within the Defence Forces. Prior to deployment, all personnel are screened as to the medication it is most suitable to prescribe for them. If there are issues around the medication prescribed during deployment, that is a matter for the medical professionals who will take the most appropriate course of action. This is about the safety, health and well-being of members of the Irish Defence Forces and protecting them from malaria. I stated in the House last week what the dangers of malaria were. We are very lucky to have lost no members of the Defence Forces to malaria, which means someone must be making the right decisions. That is totally up to the medical professionals.

Written Answers follow Adjournment.