Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House. The withdrawal of Versatis is a very serious issue. It is important that everyone realises that the medication has not been withdrawn from the drugs refund scheme and there is now a different mechanism for dealing with same. The way this matter has been approached was probably not the correct way to do so. People had become reliant on Versatis so are concerned about suddenly being advised by their GPs that the medication was no longer available under the old mechanism.

Another issue that should be of concern is that the medication is prescribed more in Ireland than in all of the UK combined. We must consider how medication and pharmaceuticals are used in this country. Over €2.5 billion will be spent on medication or pharmaceuticals in 2018, which leads me to ask if we get value for money. Is there more suitable medication available to tackle medical complaints?

In Northern Ireland, the use of Versatis is regarded as the third line of treatment and it is clearly understood that Versatis should not be used to relieve back pain. In the UK, Versatis can only be prescribed by clinicians who specialise in pain management. In the Republic, there has been a huge growth over a short period in the usage of Versatis. Why has the Republic not adopted the same stance as Northern Ireland and the UK? Why has the usage of Versatis been allowed to develop so much in this country?

This debate draws attention to how medication is used in this country. An over-reliance on medication and over-prescription of medication has been extensively reported. We definitely need checks and balances. Do we have an adequate amount of checks and balances in this area? Recently I learned about a person who attends four consultants, that each consultant prescribed medication and the case has also been referred back to a GP. Is a GP, in that instance, equipped enough to identify contraindications?

It has been mooted that we should have one file for each patient. In the case I mentioned the four consultants and the GP have probably created one file each but there is no co-ordination of the whole system. On quite a number of occasions I have mentioned the Danish system that allocates each person a patient medication card. Such a system allows a doctor to access his or her patient's file in order to see what else has been prescribed. Likewise, when a patient attends a pharmacy the prescription will have been placed on his or her computerised file. A patient simply has to hand his or her card to the pharmacist thus allowing the pharmacist to access the prescription recorded on the computerised file.

By contrast, the health system in this country uses as many as 1,700 computer systems yet Denmark has only 25 systems. As I have said on previous occasions, a huge amount of work must be done to co-ordinate health care here. We must also ensure that we get value for money in the way we prescribe and use medication. For instance, in one part of my city of Cork, over 30% of the local population are on anti-depressants.