Lynn Ruane (Independent) | Oireachtas source

I will not take too much time. I want to outline a couple of things I may seek amendments on when the Bill gets to Committee Stage. Some of them are probably for this Bill and some not, but I would like the Minister to comment on how they fit into the Bill.

The amendment to the Irish Medicines Board Act could probably also include the expansion of nurse prescribing in respect of opioid substitute treatment, OST. When we look at the role of pharmacists, we consider the role they can play given their high level of education and training. I wonder what "uncomplicated common conditions" means. What is an uncomplicated common condition? One thing I am hoping it does not include is access to over-the-counter nasal naloxone. There is a good opportunity within this legislation to name access to overdose antagonists. Has that been considered when we are looking at the pharmacies’ role? Pharmacists could provide this in the same way that they would provide an EpiPen. We have seen in the past how not having over-the-counter access to an EpiPen has led to deaths. The exact same can be said in a huge regard with respect to overdoses, but people are still slow to make that connection and to see just how successful something like naloxone can be in saving lives. It is a question of being able to access that at a local level in our community from a pharmacist the community knows. I am wondering whether there have been conversations on that.

I have another thing to mention, but it is more that I am thinking aloud. It relates to the GP contracts in general. Senator Conway mentioned the primary care centres and the idea of a one-stop-shop. When some brand-new modern buildings have been built, they still give people who use methadone and need to get a methadone prescription a completely different entrance from the one they use for every other health-related appointment they may attend. In our communities right now, we are still building buildings that tell people they need to use a separate entrance if they are there to access methadone. That is hugely concerning given that we are in 2024. We are all having conversations about addiction being a health issue, yet there seems to be some sort of health apartheid when we think of what entrance somebody may come through. That seeps down into the GP contracts when it comes to who can and cannot prescribe methadone from a GP level. I suppose it is about needing the approval of one or two individuals in relation to the central methadone list to determine whether someone can or cannot prescribe methadone at a local level, or at a GP level. Again, it is about the fact that a GP cannot be the person who prescribes the methadone, in the same way that he or she would in the case of benzos, if he or she is working with the person and he or she understands addiction.A GP does not have to get special permission to do a benzo detox in the community, but he or she needs to get special permission to prescribe or to help somebody to detox or to maintain on their methadone. There is still a kind of siloed approach in relation to some medicines. It is creating a division and giving the impression that it is not really a health issue. We are still saying that it is a health issue, but we are putting in place all these other conditions surrounding it. This Bill does not address the GP contracts, but there is space within the Bill to look at nurse prescribing and at over-the-counter access to naloxone in the context of pharmacies.