Geraldine Feeney (Fianna Fail)

I welcome the Minister for Health and Children, Deputy Harney, and thank her for giving the House so much of her time. I am also delighted to welcome the Bill which is a very workable measure. It reminds me of what happened in my last term in the Seanad when the Minister promised reforming measures in the pharmaceutical sector. This is a start.

This is not a political point, but there is opposition to the Bill for the sake of it. The main aspect of the Bill, on which the Opposition has focused, is the 50 cent per item charge. I do not know what one could buy for 50 cent; I do not believe one could buy a bag of crisps with it, or that one could buy any food item for less than 50 cent. I have the height of respect for Senator Fitzgerald and agree with many of her comments. However, she has said that if one charges 50 cent per prescription item, it will somehow lead to people not taking or not being able to afford their medication, that subsequently their health will fall into disrepair and that they could die. If that is what she is worried about, does she advocate asking the Government to give free food to people to ensure they will live and be able to feed themselves? I do not believe she would do this. It is worth pointing that out.

This is a good Bill. It is the start of the Minister's reform of the pharmaceutical sector, which I welcome. She said 2% of families with medical cards had more than 20 items per month being prescribed to them, while 35% had no items, leaving 18% with one or two. That works out, roughly, at a family having to pay perhaps €2.50. Considering the savings of €24 million that will be made, it is a small charge that might cause some pain, but those who are most vulnerable will be exempt from it. I have always found the Minister to have a heart, and she relates almost every measure in terms of the way it might affect her family to determine how it will affect families. It is in her nature to know how people will be affected by measures she might introduce.

On the category of people the Minister has exempted from the charge, it is right to exempt children who are in the care of the State, particularly with the Health Service Executive. They will not be affected by this measure. I am very pleased the Minister has exempted patients on methadone because as we have discussed in this House previously, anybody who has gone through the scourge of drug addiction and is brave enough to come off drugs and use methadone should be supported, and the Minister is rightly supporting them. I smiled, however, when I read on the Irish Pharmaceutical Union website that it was rather critical of the Minister for not doing more and referred to its customers as vulnerable patients. A little over a year ago I was very critical of the IPU when it closed its doors on vulnerable people reliant on methadone and older people who could not have their prescriptions filled. That responsibility was put on the shoulders of the Minister and the HSE to deliver the service the private community pharmacies failed to deliver. Some pharmacists had grave misgivings about the conduct of some of their colleagues but if the cap fits, wear it. Now, when it suits them, they talk about vulnerable patients but they were still vulnerable when the IPU was waving the stick and closing its doors to them.

The Minister stated earlier that long-term illness cards will be exempt from the charge. She might indicate when replying to the debate the illnesses covered by the long-term illness card.

There is a cohort of patients, mainly palliative care patients, who have their medicines changed on a daily or weekly basis. The Minister might examine that because as we are all aware, palliative care of any age group - young, middle aged or elderly patients - rightly pulls at our heart strings.

The Minister might examine also the position of people in institutional or long-term community care who may find it difficult to meet that cost. I do not know what 50 cent would buy but it is not an excessive charge when the Minister has outlined to the House the number of items being prescribed for patients in receipt of a medical card.

The Minister can correct me if I am wrong but Senator Fitzgerald pointed out that Northern Ireland has lifted its charge on prescription charges but I believe that will now be reviewed, with the possibility of the charge being reintroduced. If it is reintroduced in Northern Ireland I am sure it will be reintroduced in Wales also.

I stated that I felt the IPU was somewhat high-handed when it referred to vulnerable patients. Every patient is vulnerable. The IPU was concerned also about the way this measure would work and the negative effect this charge might have on its relationship with patients. That is being disingenuous because I cannot understand how it would have any effect. I am open to correction but I understand this charge will be levied by a computer system the Minister has already put in place on which information is held on every medical card patient. It will be done by computer rather than having a person in a pharmacy or manpower from the HSE take time out to do it. The Minister might confirm when replying to the debate that there will be no cost to the pharmacy or the HSE, and that a computerised system will be used.

I welcome the Minister's plans regarding generic drugs. More than any other time in medicine, patients now have the upper hand in terms of their own care. The Internet has opened up the market greatly for patients, regardless of whether it is a good or bad thing. If we complain of some illness or have been diagnosed with a condition we immediately look it up on Google. Many patients visit their general practitioners armed with information they never had previously, and I am sure doctors wonder why they spent half their lives at college studying medicine when patients are almost telling them what is wrong with them. However, I welcome the fact that when patients visit doctors and consultants, particularly those who do not have a medical card, they will readily prescribe the generic form of a drug if it is available.

As we are aware, a pharmacist must prescribe exactly what is on the prescription. The doctor has the right to prescribe what he or she wants but I was happy to hear the Minister say that after September she will ask doctors, in cases where a generic drug is available, to prescribe that or to write prescriptions in such a way that if the original item is not available, a generic drug would be given in its place if the patient agrees. I look forward to that measure.

I have spoken about this issue previously. We were being health and safety conscience when we introduced a quota on the number of pain-killers that could be bought over the counter. One is not allowed purchase more than 12 Panadol, Disprin or whatever in a supermarket or pharmacy yet I have seen and heard of medical card patients being prescribed 100 pain-killers a month on a prescription. I am aware of a lady who went to clean her mother's house after she had passed away and found 600 Panadol. I hate to think what could have happened if those Panadol had got into the wrong hands. There was enough Panadol in the House to take the lives of ten people. That is where the waste is, and I support the Minister's Bill in trying to clean up what has been going on in that regard.

I look forward to the introduction of prescriptions for generic drugs. We can all go abroad and buy pain-killers for a fraction of the price they can be bought here. One can buy 100 Panadol in France, Spain, Portugal or wherever for as little as €2 but we pay €3.50 here for 12 Panadol. The Minister gave an undertaking when she took on the health portfolio that she would reduce prices and she has kept her word on that. I welcome the Bill and look forward to the debates on the remaining Stages later.