Colm Burke (Fine Gael) | Oireachtas source

Senator Cullinane is correct that the increase in the number of medical cards is a reflection of the decline in people's incomes. In the past two years, the Government has acted in a caring manner by ensuring people have an entitlement to access the services they require. Some tweaking and tidying up is needed in health care and the Bill proposes only a small change. The figures for 2012 show that we were issuing approximately 14,000 medical cards per month, a significant number that reflects the Government's commitment to ensure people on low incomes have access to health care.

Senator MacSharry referred to delays in the health service. The Hanly report of 2003 recommended increasing the number of consultants to 3,600 by 2012. The current figure of 2,500 consultants is 1,100 short of the target. However, in light of the change in the country's financial position, it will be difficult to implement the recommendations set out in the report.

I welcome the decision to bring the rules pertaining to cohabitants into line with the provisions of the Civil Partnership and Certain Rights and Obligations of Cohabitants Act of 2010. Income is not calculated on the basis of gross income, for instance, in calculating net rental income allowances are made for certain expenses. I presume the property tax is regarded as an expense. Perhaps the Minister will clarify this matter as the Bill is a little unclear in this regard. Having said that the Bill has been carefully drafted to ensure income received from redress payments or compensation payments made as a result of an accident is not taken into consideration when calculating a person's net income.

The health service presents many challenges and many issues need to be tackled. I refer specifically to the cost of drugs, an issue in which I have taken an interest in recent months. The efforts being made by the Department in this regard are not insufficient. The Sunday Business Post and other media outlets have reported on the costs of medication, which were also the subject of a recent report by the Consumer Association of Ireland. Susan Mitchell in The Sunday Business Post noted price differentials for medicines between Ireland and other European Union member states, with some items costing 25 times more here than in the United Kingdom. Domestic price comparisons show major variations in the price of drugs in different pharmacies in the same town or city. We must carefully examine this issue.

In 2000, the State spent ¤574 million on drugs. By 2010, this figure had increased to ¤1.894 billion, an increase of 230%, and I understand it is set to exceed ¤2 billion this year. The Department should set a target for reducing expenditure on drugs as it is a major element of the health budget. It would not be unreasonable to set a target of reducing the drugs bill by 25% or ¤500 million. This would necessitate addressing the problem of over-prescribing. I spoke recently to a person who had worked and lived in England for some years and expressed astonishment at the much higher rate of prescribing here than in the UK. While medication is very important, its overuse can have negative long-term effects, such as increasing immunity to the treatments being prescribed. We must work on this issue in the next 12 to 24 months.

While I am open to correction, I understand 90% of all income tax revenue is allocated towards meeting the cost of health care. A further 14 Departments must be funded from income tax revenues. We need to reduce costs in the health service without reducing the level of service. The Minister, Department and Health Service Executive have an important task in ensuring we obtain value for money for health care expenditure in the next ten years.