Wednesday, 1 February 2017
Health (Miscellaneous Provisions) Bill 2016: Second Stage
I will be very brief. I welcome the Minister of State to the House. I commend the legislation, which we are very supportive of. It addresses a number of important key issues. I particularly welcome the measures taken in respect of those who have been identified under the thalidomide scheme, the Lourdes hospital payments scheme, the symphysiotomy scheme and of women who were residents of certain institutions. I have a number of concerns about the symphysiotomy scheme overall and how it has been administered but that is not a matter for today.
Today we should recognise a positive gesture in terms of access to the fair deal scheme. There are, however, two wider issues that need to be pointed out. First, what measures or information schemes are there to ensure people are made aware of this measure and aware of some of the other specific things included and covered in their scheme? I know there has been concern in the past about women who have been eligible for previous schemes and who are now living abroad but who may potentially be thinking about returning to Ireland to retire. Many such women and their families may be currently resident in the UK and elsewhere. What plans are there to ensure awareness of this measure and of the other supports and social protection provisions that can be accessed by such women?
I would also really like to point out that, while this Bill identifies specific schemes, we need to look to a wider principle. Over the next year I hope to work with others across the House to consider some of the wider principles of redress and how we engage in redress or restorative justice for institutional violence or wrongs of various forms. This Bill is an example of the kind of good practice that we would want to include in that, along with other important principles, such as really re-examining the use of waivers as we currently have them and the principle of first person testimony and how it is reflected. I welcome this very much.
I welcome discussion on the pricing and supply of medical goods. Particular concern has been highlighted with regard to the morning after pill and emergency contraception. I am aware that it is something the Minister of State's colleague, Deputy Kate O'Connell, has raised and championed at various points. As a pharmacist, she understands the issue very well. I am also aware that there are groups, including a very good and vibrant campaigning group called Real-Productive Health, which have really sought to put this on the agenda. I may table amendments to the Bill to move this issue a little further along, but I am not sure if I will. The Minister of State spoke to it earlier, but could she clarify exactly if it is now the case that over-the-counter drugs will definitely be available without a prescription to medical card holders?While it is available without a prescription, I suggest that medical card holders would be able to get it on the medical card scheme without a doctor's prescription. Obtaining a doctor's prescription is a considerable problem with a time-sensitive issue and requires securing a doctor's appointment and getting the consultation. It causes serious concern and with respect, I suggest that the fact that 12,000 people may have used it and achieved a prescription is not an indication that there are no obstacles. We only know that 12,000 people have got a prescription. We do not know how many may have found themselves delayed from accessing it, whether it was 5,000, 4,000 or 10,000, and because of our laws in other areas we do not know what the consequences might be and we have no way of measuring those who did not access emergency contraception and who dealt with the consequences of that in whatever way. That is information we do not have.
Many, including me, believe there are real problems with the conscientious objection clause as it is currently operating where pharmacists are concerned. As the Minister of State rightly said, this is the pharmaceutical industry's own administration. It is something which we have lobbied them about in the past. There are concerns which relate to the State, including whether the alternate provisions, which are being recommended by those pharmacists who are exercising that objection, are adequate. Perhaps we need to have an examination of whether alternate provisions are feasible. In rural areas, do they reflect the transport constraints, particularly on weekends?
Another concern I have in that regard arises on Sundays in rural areas in particular. While pharmacists have a Sunday rota in some parts of the country to ensure a pharmacist is always available, that is not the case in other parts of the country. This is something on which I might consider an amendment or the Minister of State might tell me of other ways in which the introduction of a Sunday rota system might be addressed. Again, I would like to welcome that and seek a little more clarification on how the Minister of State envisages this fitting in with the other provisions mentioned that are being considered by the Minister, Deputy Harris, to increase and support access to these vital and time-sensitive measures.
My last point is on the regulation and setting of a standardised maximum price. We know that with emergency contraception, the price of the same drug can vary from €25 up to €70. These are amounts which are not readily available to many of our citizens and certainly not necessarily readily available within a matter of hours. The Minister of State might let us know what she is thinking in terms of the standardised maximum pricing and how to address the case of medical card holders.
I want to echo others in giving my full-hearted support - and I believe that of the rest of our group - to plain packaging and these important measures on plain packaging. I again raise the question, as others have, of the Public Health (Alcohol) Bill 2015 as the matter of plain packaging underscores the question of the power of suggestion, advertisement and visibility. It is a reminder to us that persistent suggestion, which we have in many cases in our lives, including the easy visibility of alcohol products in spaces such as grocery stores, is an issue and a concern. It underscores all the evidence which shows the power of that suggestion and I will conclude by stating I support it. We also will provide strong support to the Minister of State on the Public Health (Alcohol) Bill 2015. I urge that we move expeditiously through this because I share the same concerns regarding the Comprehensive Economic and Trade Agreement. If we move towards its full implementation, we will leave ourselves open and regulation is now imperative because unfortunately, new regulation will face new obstacles and new threats in the future.