Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I accept that other issues were raised, but given that we are already over time and that there will be two further debates in the Dáil shortly, I will confine my remarks to the particular issue, on which I thank Senators for having a rational debate. Sometimes when these issues are debated in the media, the debates are not rational. I am glad that the debate in this House has been.

To respond to the remarks made by Senator Gerard P. Craughwell, this is not just about price, as we reimburse much more expensive medicines all the time; it is also about effectiveness.

I agree with the remarks made by Senator Marie Moloney who is absolutely right in that all medicines have side effects. In deciding which medicines are to be reimbursed one needs to take into account the side effects profile because real harm is caused by medicines all the time. In fact, probably more people die in hospitals every year as a result of medication errors and inappropriate medications than, say, as a result of MRSA. Therefore, the side effects profile needs to be taken into account. It is not the case that all drugs do not have side effects; of course they do.

Senator Marie Moloney also said we needed to negotiate harder with the drug companies and she is absolutely right. That is why the most effective approach by this Chamber is to exert pressure on the manufacturers to put pressure on the industry to reduce its prices, rather than always pressuring the taxpayer to pay more. I hope Senators will take this into account.

On Senator John Crown's remarks, I am sorry if I was not clear. The reason the NHS and the London New Drugs Group - this has nothing to do with Ireland - decided not to reimburse the drug was that it worked for less than half of patients, and even for those for whom it did work, the average improvement in walking was 0.3 to 0.8 of a second, only slightly better than the rate for a placebo. That many drugs do not work for all patients is not new, but for those whom it did work, the average improvement was minimal. That is not to say there may not be a smaller sub-group who have responded and for whom the drug may work very well. That is a possibility, although the evidence does not yet support it.

I note what was said about PR advisers and take the Senator's point. We should apply the same rules to all Government spending. If I was to be mischievous, I might suggest we apply the same argument to the Seanad. As somebody who actively supported its abolition, the cost of maintaining this Chamber would be better spent on the health service, but we have had that debate. Certainly, if this Chamber wants to talk about rational spending, I will happily-----