David Norris (Independent)

I welcome the Minister of State. This is an important Bill. Anything that reduces the charge to the State of the medical service is welcome, in particular in the difficult circumstances in which we find ourselves. However, there is a balance to be struck. I am not a big fan of pharmaceutical companies but there is no doubt whatsoever that there are research and development costs involved in producing new drugs. For every drug that is successful, a number are unsuccessful. Scientist are engaged in the production of these products and sometimes they fail at spectacularly late stages in the trials of the drugs. We had the classic example of Elan which appeared to develop a wonderful drug, Tysabri, that was used in the treatment of a most horrible disease, multiple sclerosis. Rather sadly, it appeared to have significant side effects which made its continued sale problematic. This is the kind of thing which can confront pharmaceutical companies. Although I am by no means a supporter of pharmaceutical companies, and think that some of them in the past have proved to be nothing other than highway robbers, at the same time there is this balance to be struck.

I welcome the fact the Minister indicated that this Bill is patient-focused. My colleague, Senator Quinn, who spoke earlier made a career in business by saying the customer was king. In the health service, the patient should be regarded with due respect and as one of the most significant elements in the equation. This is not always the case, so I am very glad this is patient-focused. However, we are dealing with an ageing population, which increases the requirement for drugs, and with more sophisticated drugs. Situations which simply had to be tolerated before can now be addressed by expensive drugs. We are moving into an area where choices may have to be made. I am realistic and accept human beings, including myself, are perishable goods. I happen to think that death is one of the best inventions for which God was responsible, otherwise we would be in an intolerable situation on the planet. However, I understand the very human desire to keep going for as long as possible with whatever pharmaceutical assistance is available.

I welcome the reduction in pricing but I have a certain number of concerns. I was a little bit confused when the Minister spoke about the cost of drugs and said that the magnitude of expenditure on medicines and non-drug items such as dressings in the public health service cannot be underestimated in 2011 and that this expenditure amounted to just under €2 billion. I am not sure what the difference between medicine and drugs is. I am sure there is a distinction and perhaps we could be advised as to what precisely it is because if I go into a chemist with a prescription for a medicine, I presume it is a drug. There is a difference with Elastoplast. To my mind, even Aspirin is a drug.

While I am on the subject of drugs - this is a slight digression - on the Order of Business today there was a lot of talk about O'Connell Street, the awful things that happen, all the druggies and so on. I think we have to remember that these people are human beings. I live at the other end of O'Connell Street and I walk that street every night and will walk it again this evening. I meet drug using people - I met two last night. They were an absolutely wonderful couple and my heart went out to them. They were the remains of a very beautiful pair - a young man and a young woman. The woman was the stronger of the two and was desperately trying to get her companion off heroin. There is not sufficient provision in terms of methadone or, indeed, trying to get people off methadone. We should support these people instead of writing them off as human garbage to be swept aside. We should understand that they are human beings. I had a conversation with them the length of O'Connell Street. They did not threaten me with any violence. They were not rude but they were in despair and we need to do something to help them.

Section 13 may be unlucky for some because it gives a prescriber the option of indicating on a prescription that a branded interchangeable medicinal product should not be substituted if there are clinical reasons not to do so. I would have thought that if something was condraindicated and, for example, it could be damaging to one's liver to take a particular thing, there is an obligation on a doctor in this regard. I do not think it should be an option if the doctor feels like indicating it. The responsibility of the doctor is to the patient. Unless there are reasons against it, I would like to see this section strengthened, if possible, so that the doctor is required in circumstances where there could be damage to the patient's organic well-being to ensure that drug is not prescribed. I note there are clear attempts to ensure generic drugs are as safe as the non-generic ones. There is a time period after which the patent runs out and this allows for the kind of experiments about which I talked and the cost of these and so on.

I would like to raise the question of AIDS. This is a national and international situation and I hope Ireland will continue to play a role internationally in putting pressure on the drugs companies because the combination drug therapy for AIDS is quite astonishingly successful to someone of my generation who saw so many people I knew die in very difficult and traumatic circumstances. Luckily for many people in this country, this combination therapy is available and has remarkable results. In the rest of the world, this is not always the case. I would approve of any move which made these generic drugs available in sub-Saharan Africa. Pressure must be kept on the pharmaceutical companies.

I welcome the Bill, which is a good one. I know there may appear to be an irony in the fact that this side of the House suggested it would take all Stages of the Bill but I think that shows responsibility. I usually oppose this - I am not a member of any party, so there is no party advantage - and think it is bad political practice to take all Stages of a Bill. I have always objected to it but in this case, I would have happily consented to it if it was of help to the Government and the patients. For some reason, this appears not to be possible, which I regret. However, I am not making or attempting to score a party political point. I invariably oppose this procedure but there are times when one must be politically flexible and I would have agreed to it had the Government chosen to put all Stages of the Bill before the House today.