David Cullinane (Sinn Fein)

This Bill is very welcome. All of us hoped it could have been before the House much earlier, but it has arrived now and we support it. It is unfortunate that we cannot complete the legislative process before the summer recess. Members would have preferred if it had been possible to deal with it before the summer, but we must wait until we return in September to finalise the Bill. That is unsatisfactory but at least we are making some progress.

Generic substitution and reference pricing have been talked about for a long time. There is no doubt that this Bill will save the State significant amounts of money. I do not know if the Minister was listening to the radio recently but there was a great deal of commentary about him in respect of many issues. There was a very good discussion on one of the morning programmes on RTE Radio 1 on this issue, and a number of people rang the programme to talk about their experience of over-prescription and the waste of medicines. All of us can provide such stories. When my paternal grandparents were alive we had to get their doctors' prescriptions filled. Often one cannot read what is on the prescription; one simply hands it over to the pharmacist and receives a bag of medicines. When we got home we regularly discovered that most of what was in the bag was already in my grandparents' home. The same story was told by dozens of people. It is a constantly recurring experience. Aside from the fact that we need to reduce the cost in terms of general practitioners issuing prescriptions for branded drugs and the pharmacist having to provide those drugs, there is also a problem with over-prescription and a need to have a proper regulatory oversight mechanism to ensure that a pharmacist can see what medicines are being prescribed, how often they are being prescribed and to make rational decisions about dispensing medications which, in some cases, might be unnecessary. Of course, that is difficult to legislate for but it is something that must be examined.

The HSE spent an estimated €1.9 billion in 2010 on medicines and non-drug items supplied to patients under the GMS and community drug schemes. This includes approximately €384 million paid to community pharmacy contractors in respect of dispensing fees and retail mark-ups. Savings were made last year through some reforms but all of us accept that a great deal more can and should be done to achieve savings over the next few years. In fact, this issue featured in Sinn Féin's pre-budget submission in 2008. It is something we have lobbied previous Governments to do and we have put forward proposals on how this could work. I am pleased the Government is dealing with the issue, albeit a little late. It could have been brought forward earlier but it is welcome. We must deal with other issues to address the cost of medicine in our health care system. Sinn Féin has called for the establishment of a State wholesale distributor of drugs. It could be used as a mechanism to save the State money. The expansion of the role of pharmacists to include medicine use review to help ensure patients get optimum benefit from medication and to help the reduction of waste should also be considered. The Minister for Health should initiate a comprehensive national audit of drug prescriptions in hospitals and in the community. That would be helpful to guide us on where savings could be made.

In opposition, the Minister of State agreed with the following point when the then Minister, Mary Harney, introduced the notorious prescription charges for medical card patients.