Fidelma Healy Eames (Fine Gael)

The review also found that the failure to take prescribed medicine has a direct adverse effect on health and results in increased use of health care services and higher health care expenditure. All my points show that the 50 cent charge is short-sighted and is merely a Band-Aid to a bullet hole.

The conclusion of the Cochrane Collaboration review is that "increasing cost-sharing may present a financial barrier to poor households for patients with chronic conditions who need high volumes of pharmaceuticals" and that pregnant women, children and older people are particularly most likely to be negatively affected. Harm is less likely if charging is introduced for non-essential drugs and if exemptions are built in. There is some sense in bringing in the 50 cent charge for non-essential drugs. I ask the Minister to consider seriously not introducing it for drugs that are life sustaining and drugs for chronic illnesses. Has she considered this?

The journalist Sara Burke states: "In most European and OECD countries, there are some charges for prescriptions, but not for the poorest 30 per cent of the population. In Wales, there have been no charges since 2007. In England, Scotland and Northern Ireland, certain groups are exempt from charges, such as people on low incomes, people with chronic diseases, pensioners, pregnant women, children and cancer patients. In England, more than 85 per cent of the population is exempt." Northern Ireland and Scotland are phasing out charges for everyone in the next two years.

The British Medical Association chairman stated: "Abolishing prescription charges is the fairest and the simplest option [...] if all patients could get the treatments they needed via free prescriptions it may reduce hospital admissions and costs for the health service in the long run." While the Minister will save a certain amount for the Exchequer in the short term, she will impose a cost on the health system in the longer term. Her record and reputation in the health system are not strong; they are notably weak. Why do more damage and harm further her reputation and that of the Government?

The amount expected to be raised through drug charges this year is €42 million and it is expected to be €52 next year. Medical card holders comprise the poorest 30% of the population and increasing charges from €100 to €120 per month will hit those on lower incomes the hardest.

The Minister says she wants to discourage over-prescribing, for which I applaud her, but I reiterate that patients do not prescribe drugs. If one wants to change prescribing and dispensing practices one must speak to doctors and pharmacists, not the patients. This very point was supported in last week's article in The Sunday Times by Sara Burke.

I wish the Minister well but ask her to think about those with chronic illnesses and those on low incomes, whose lives she may be risking. That is what we want to prevent.