Mary Harney (Dublin Mid West, Independent)

As for patients, I mentioned earlier on Committee Stage that at present, the HSE is involved in 100 medication usage reviews involving 16 primary care teams nationwide, as well as the local pharmacists. Its purpose is to acquire good data on the use of medication. It is known that 45% of medication prescribed and dispensed is not appropriately used and 20% of people do not take their medication at all. It is clear that none of this makes sense from either the patient safety and outcomes perspective or the cost perspective. In future, health care professionals, including pharmacists, doctors and nurses will engage more fully with patients on the significance of medication usage.

On the question of exemptions, I have provided for children in care, as well as for those who are on methadone. In addition, there is provision in the legislation that is about to be passed for the Minister to make regulations excluding other categories of people from being obliged to pay the charge. This will be based on the evidence as it emerges. Clearly, anyone with a long-term illness card, which includes all diabetics, will not be obliged to pay the charge. This also is true in respect of mental health patients under the age of 16 and a whole category of others that I read out previously. There are approximately 20 different categories of patients to whom this charge will not apply.

However, everyone will be expected to pay the charge when he or she presents his or her prescription to a pharmacy. Senator Feeney made the point, which I now reiterate, that it is unlikely there will be much evidence of people failing to receive their medication for the lack of paying 50 cent. I acknowledge that such charges were abolished last April in Northern Ireland and do not apply in Wales. However, in virtually every other country throughout Western Europe, as well as in Australia, New Zealand and North America, there is co-payment, even for very poor people, in respect of prescription charges or doctors' visits or both. This is new territory for Ireland and the Department will keep this charge under constant review. I gave a commitment to report back to this House and to the Oireachtas joint committee on any significant issues that may arise in the context of implementation of this charge. Were any category of citizens not taking their medication because the charge was prohibitive, clearly that would be something that any Minister for Health and Children would be obliged to take on board.