Mary Harney (Dublin Mid West, Progressive Democrats)

It would take me an hour to answer all the questions posed. Instead, I will make several observations with particular focus on the point made by Senator Quinn and others. Life expectancy is one of the international measures used to compare health systems. Between 1999 and 2003, life expectancy in Ireland increased by three years. A child born in Ireland today will live longer than one born in the United Kingdom, Belgium, the Netherlands, Germany or Denmark. That is a measure of achievement. The numbers dying from heart disease in the State have dropped by 54% in the past eight years. The survival rates for pancreatic cancer have improved by 31%, by 24% for prostrate cancer, 14% for lung cancer, and 9% for breast cancer. The OECD recently described this improvement as one of the fastest in the world. We are top of the class in regard to children's cancer, ahead of the United States and the rest of Europe.

I make these points because one might have an entirely different impression of the health service based on the debates in these Houses. One aspect of the problem in this regard is that some of those working in the public health system like to criticise it. That is quite unusual. One never hears a member of staff in a private hospital criticising that institution in public. However, such criticism is frequently heard in the public health system. It is a great pity.

Criticism was directed at me yesterday in view of the announcement that a private company's contract to supply hospital in the home services was not being renewed. I am normally criticised because such contracts are being given to private companies. That was mentioned during this debate. The reason the contract is not being renewed is that we have capacity within the public system to provide the service.

In regard to the dispute between the Health Service Executive and pharmacists, we all would agree that health care professionals, above all else, take their ethical responsibility seriously and generally put patients first. If there is an industrial relations dispute or, as in this case, a dispute over money between the HSE and pharmacists, the priority must be that patients should not suffer. We are all entitled to expect that. Pharmacists receive €100,000 more per year in dispensing fees than their counterparts across the Border. Furthermore, it costs us €600 million, a margin of 17% to 18%, to take €1.1 billion of drugs from the producers to the patients. I am not an expert on Senator Quinn's business but I doubt he would pay €600 million to take €1 billion of product to customers. It is a huge margin and double the EU average.

We are not reducing the money going to pharmacists. Our objective is to stop the huge rise in the cost of drugs. The cost is rising so rapidly that it has the capacity to consume all the additional money we can make available to the health services. The agreement between the 1,600 pharmacists and the HSE is to get a dispensing fee for the general medical service, GMS, scheme of €3.27, a dispensing fee for the drug payment scheme and a 50% mark-up. There is no agreement between the pharmacists and the HSE to pay a distribution fee for anything. Nor is there any agreement between the wholesalers and the HSE in regard to distribution. When the HSE recently put to tender the contract for the distribution of certain products, the successful company won it on the basis of a 4% margin.

I established a three-person group because the Irish Pharmaceutical Union, IPU, representatives made the case to me that the HSE is the procurer of 70% of the service they provide and that an independent process was required. I put in place a group of three led by Mr. Sean Dorgan, former chief executive officer of the IDA and Secretary General in two Departments. The group also includes Mr. Mark Moran, who previously worked in the pharmaceutical sector and was formerly chief executive officer of a Dublin hospital, and Ms Mary O'Dea, consumer director of the Irish Financial Services Regulatory Authority. These are all highly regarded individuals. They have been given until the end of May to report on this issue. IPU representatives met the group last week, as have other interested parties. I appeal to pharmacists to give that group a chance. We are talking about a matter of four weeks from 1 May. I really hope that can happen.