Nicky McFadden (Fine Gael)

More preventive measures such as this might save massive amounts of money.

The number of items dispensed under the GMS and long-term illness schemes increased from 35 million in 2004 to 48.2 million in 2008, a very significant number. Like other Members, I accept that we are in very challenging economic times, but a 50 cent charge per prescription item, subject to a monthly ceiling of €10 per family, constitutes a serious expense for those who have absolutely nothing. While the Minister expects to raise a sum of €50 million in 2010 and €25 million in 2011, Fine Gael believes the prescription levy will mean that some of the poorest and most vulnerable patients with serious illnesses may be obliged to go without their medications, despite what Senator Feeney said. While the levy of 50 cent per item may not appear much to the Senator or me, if one is in receipt of a weekly social welfare payment of €160 and must budget for everything from that small amount of money, it constitutes a great sum of money. Senator Feeney should note that it can mean the difference between food on the table and medicine. International research shows that any disincentive to take medicines should be avoided, as some patients inevitably will end up in hospital or in care.

One parent families are seriously threatened in this regard. I refer to the intention in the budget to cut the single parent family allowance when the child concerned reaches the age of 14 years. Such persons are in the category most at risk in Ireland of being in consistent poverty, which means their basic necessities cannot be obtained. They which will forego medicines either for themselves or their children.

I accept there is huge waste and that methods must be figured out to avoid costing the Exchequer lots of money. However, I note that in other jurisdictions the prescription levy has been abolished. Senator Feeney suggested consideration was being given in the United Kingdom to the reintroduction of such a levy. However, I find this to be strange. As the levy was only abolished on 1 April, I hardly imagine the authorities there plan to reintroduce it so quickly. The British Medical Association has called for the abolition of prescription charges because it claims such charges are outdated, detrimental to the health of patients and, as I pointed out, act as the barrier to taking necessary medications. I wonder why the Minister is going against the tide of international experience in this regard.

As I stated, I accept savings must be made. However, the assessment of Cochrane Collaboration, a United Kingdom-based organisation, is that charges do not reduce the cost of the drugs bill in the short term. Moreover, some reviews and studies have shown that there are increases in admissions to accident and emergency units and hospitals because patients who cannot afford to take their drugs stop taking them entirely. Consequently, this will have an adverse effect on people's health. In particular, I refer to the health of patients on long-term medications such as those with mental health issues. There is a psychological impediment in respect of such vulnerable patients, as a number of speakers noted. They may stop taking their medications altogether. Having worked in this area, I know this to be the case.

Section 1 of the Bill contains room for exemptions. In common with other Members, I ask whether the Minister intends to exempt patients with cancer or pregnant women. Alternatively, a patient who has recently presented with diabetes and is being regularised may be obliged to obtain different drugs to establish a regime. Will the Minister consider an exemption in that regard? I do not advocate that one should support pharmacies because they are a well organised profit-making body, but last year their representative organisation introduced and suggested a great number of ways of prescribing generic drugs.

Has the Minister considered any of their proposals?

The other question relates to pharmacies having to collect the money. What will happen where a patient refuses to pay? Has the Minister considered this possibility? If patients exceed the figure of €10 in a month, how will the amount overpaid be paid back. How will the scheme be administered? In a 12 month period the cost could amount to €120. What system will be put in place to refund any moneys overpaid? The Minister tried to introduce a system to take back the medical card from the over-70s and now she is introducing a levy on prescriptions.