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Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Inevitably, I must ask Mr. O'Brien about top-up payments. I appreciate the comments that Mr. O'Brien made in his opening statement to the effect that he regards this as an important issue to be tackled and I am absolutely at one with him in that regard. To be clear, how many people are involved in these top-up payments? Are all the institutions involved section 38 institutions?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I presume they are all on high salaries, without the top-ups.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: What of sort salary does grade 8 correspond to?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: They are all rather well-paid or seriously well-paid staff. How will the HSE's work on this pan out? Clearly, the situation must be resented by the staff in those institutions who are subject to the full rigours of Haddington Road and so on. It must be having a detrimental impact on the workings of those institutions because of bad feeling so on.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Is Mr. O'Brien referring to those 143 people?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Are the top-up moneys actually coming from State coffers?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I am keen for Mr. O'Brien to name some of the main institutions involved. I can probably guess many of them. Is there any way they could plead inability to pay on the grounds that the State is living beyond its means still, despite all the adjustments we have made?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I presume we are talking about some of the institutions that have been before the committee already, such as St. Vincent's University Hospital and the Central Remedial Clinic, although the CRC has probably changed at this stage.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I appreciate that.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Are they still swinging towards compliance?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Is the determination on their part, the HSE’s part or on the part of both?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I wonder.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Am I right in taking it that the majority of staff in those institutions are subject to the Haddington Road agreement?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Does that not give the HSE an angle, if some had been approved under the Haddington Road agreement?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: We will get the full picture then.

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: I appreciate that. I thank Mr. O'Brien. While there have been some reductions in medical prices, it continues to be a source of amazement to the average man and woman that there is such a discrepancy between what people pay for drugs dispensed by pharmacists in Ireland and what they pay in the UK or Spain. Can Mr. O’Brien fill us in on the progress made in that regard? That would...

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Can Mr. Hennessy give us some figures on that?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: What is the total?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Why are medicines so expensive? People suspect that general practitioners, GPs, urge people to take particular brands. Does that have a bearing on the cost?

Public Accounts Committee: 2012 Annual Report and Appropriation Accounts of the Comptroller and Auditor General
Vote 38 - Health
Vote 39 - Health Service Executive
Chapter 21 - Budget Management in Health Service Executive
Chapter 22 - Eligibility for Medical Cards
(12 Jun 2014)

Robert Dowds: Can Mr. Hennessy examine that to establish the extent to which individual GPs are prescribing the cheaper alternative? I would not want them to do so in a way that would be detrimental to a person’s recovery.

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