Phil Prendergast (Labour)

I welcome the Minister. I am pleased to have this opportunity to contribute to the debate. The Labour Party is opposed to the proposed charge as it represents hardship for people with long-term illnesses.

Will the projected savings of €2 million per month mean there will be a review of cuts to respite care, home help hours, special needs assistants in schools and home care packages? A total of 467,926 people are aged over 65 years, with 8,959 in receipt of home care packages. I question whether this proposed measure will have positive implications at local level because different areas of the country have differing medical needs. For instance, people in some areas are more prone to chest conditions.

I refer to the point made by Senator Fitzgerald. Patients requiring medication may become reluctant to ask for the medication because of the charge. Senator Feeney referred to the 2% of families with prescriptions for more than 20 medications. The important word is, "prescribed". One has to allow for the fact that doctors, pharmacists and nurses can prescribe and no patient will be prescribed medication which they do not need. Medications are reviewed constantly to take account of changing needs of the patient or as new medications become available. If a patient requires additional medication because of a developing condition, this may necessitate a review of all pharmaceutical effects of his or her combined medications.

This charge is a tax on illness and is an extraordinary measure. How was the charge arrived at? I have some questions about some of the aspects of the Minister's contribution. A total of 80% of prescriptions are written for the branded form. Will the Minister change this practice? Drug companies make patent drugs to retain their exclusivity. Will there be a change in manufacture? I question why the end-users must pay this charge when this charge could best be levelled higher up the chain rather than on the people who need the medication. A charge of 50 cent could easily be absorbed higher up the chain without affecting the people, the end-users.

Senator Fitzgerald made the point whether there is an administrative cost to this charge. I question whether it will involve form-filling and whether there will be a review or appeals system if people believe they have been unfairly levied. Will the implementation of this charge require additional staff or will staff be relocated from other work? This is what happened with regard to the cervical vaccine and the H1N1 vaccine programmes where nurses have been reassigned to implement these programmes and child developmental assessment clinics have not been held. The moratorium on staff recruitment has prevented the filling of 120 public health nursing positions and is having a significant impact on primary care.

I refer to subsection (1A) of the Bill:

Subsection (1A) provides that a person who is supplied by a community pharmacy contractor with a drug, medicine or medical or surgical appliance on the prescription of a registered medical practitioner, registered dentist or nurse (who is entitled to prescribe) shall be charged 50 cent per item.

Will the Minister comment on the fact that where crutches are given to people requiring them and for which there is currently no charge those crutches cannot be used again by anyone else. Will the Minister clarify why this is the case? I researched the cost of a pair of crutches. I could only find a price in England where they cost £16.99 a pair. I presume this would translate to €50 a pair, given the difference in VAT and the fact they may be used on rough terrain here. I know from personal experience that many households have crutches which cannot be used again. It seems extraordinary it this seems to be the policy not to recycle this genuinely reusable medical appliance. For instance, there are currently three sets of crutches in my house and I would be very happy to bring them anywhere they are needed if there is a crutch amnesty. I tried to return them but they were refused.