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Health (Pricing and Supply of Medical Goods) Bill 2012 [Seanad]: Second Stage (Resumed) (Continued)

Monday, 17 December 2012

Dáil Éireann Debate
Vol. 787 No. 2

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(Speaker Continuing)

[Deputy Catherine Murphy: Information on Catherine Murphy Zoom on Catherine Murphy]  The other point relates to those who are on drugs that suppress seizures. Sometimes these drugs can have other side effects where it is a matter of finding the right drug and finding the right balance. There might be a 10% tolerance in finding exactly the right balance and to upset that balance will be very problematic for potentially 40,000 people who are doing well. For example, the changes that occurred for those with epilepsy in the past 30 or 40 years have been immense. It has been a good news story for so many because it has given them back their independence. It has made them feel confident again because they can have some control over their lives. Often epilepsy takes away that control at key times in a person's life, for example, when one is a teenager and has so much else going on. Recently, I was dealing with somebody where a youngster got a poor leaving certificate because she had epilepsy in that year, was going into college, was maintained on the drug and was doing well. We will spend a great deal putting that youngster through college but one wants her to go through at the best of her ability, and it is important to have her epilepsy controlled.

I cannot stress enough the importance of there being provisions in the Bill that allow for specific conditions such as epilepsy - I am sure it is not the only one. Such conditions will be the exception. Generics can contain very much the same ingredients and work well with most conditions, but conditions such as epilepsy are different. There are other countries that make exceptions when using generic drugs. Denmark, Germany, Portugal, Spain, Sweden and Switzerland all exempt epilepsy. Where there has been good reason to deviate, it makes for good health policy to do that.

One of the most expensive elements of producing drugs, which we cannot address in this legislation but which might be something that we can advance at the European Union, is packaging and the various individual sets of instructions. Clearly, there are language difficulties in the European Union. Having said that, there are significant variations in the health regimes in the various EU countries. That is costing significantly more than it needs and it is something that should be picked up at some point through the appropriate Commissioner in the European Union. It is important to point out that the variations involve a needless cost. Then there are some countries, such as Ireland and the United Kingdom, which do not have a difficulty with language, yet something that is sold in Northern Ireland could not be sold over the counter here because it has an entirely different set of instructions. One might not be able to do it for all of the countries but one might be able to provide for elements of uniformity in countries that would be similar in terms of language. This would be another way of cutting costs.

One of the big savings that was hoped for this year in the health service that did not materialise was the reduction in the cost of drugs. Some of that was to do with the basket of countries against which we price ourselves. Clearly, this legislation will provide for that for next year. It is important that we are not wasteful. Invariably, when people who are abroad on holiday and become ill or suffer from asthma, they can buy drugs over the counter which are only available on prescription here, and the variation in price is astonishing. Not only will this potentially save the State a great deal of money but it will save individuals, who are just on the margins of availing of a medical card, a great deal also. It is really important that we ensure that people retain money in their pockets if at all possible, particularly at this difficult time.

I want to raise a matter that is on the fringe of this. There is a need to have a health system that is about health, not about illness. Until we have a decent primary health care system, we will not have that. There are patients turning up very late for diagnosis and if there was a decent primary health care system we would save money and keep people healthier. Too much of what has happened is the result of the notion of measuring health in terms of the number of patients who are no longer on hospital trolleys or who are able to get procedures in the acute system. It saves a great deal if conditions, such as diabetes, are diagnosed and treated much earlier. We cannot get to a point quick enough where there is a decent primary health care system because we all will benefit from that.

There have been newspaper reports of cancer patients having to pay for their medications. That is not new. I recall a family member having to do it five or six years ago, and it took me completely by surprise. It seemed to be one of the few situations where a person turns up in a crisis, as one does when one has been diagnosed with cancer and is possibly only over a major operation, and then goes on to chemotherapy only to be handed a bill of €56, €70 or whatever. In some cases, one would question whether the person has such sums in their pocket. It seems strange. In most circumstances, that would not apply. I have never understood why it applies in the case of cancer. However, it is not a particularly new departure. I would like to hear a response as to why it happens in the first instance.

Deputy Bernard J. Durkan: Information on Bernard Durkan Zoom on Bernard Durkan I am glad of the opportunity to speak on this Bill. It has been a long time coming. It was a commitment made by the Government parties when in opposition and was part of the programme for Government. We hope that the Bill, like all of the other Bills on which we speak in this House, will achieve its purpose, which is an important aspect of any legislation.

We all are faced with a difficult time in spending in this country. Cost cuts must take place in respect of almost every service. It is a tragic position to be in but that is the way it is. The suggestion put forward in some quarters that some cuts are painless and that others can be diverted to other areas is not the luxury that people can readily live with. In all budgetary situations, cost savings and cost cuts are measures that hurt everybody. Whether in full health or ill, there is an impact. In some cases we can do nothing about it other than to try to make the best provision we can to deal with the situation even in the face of such a budgetary situation.

My colleague, Deputy English, referred to an issue I can never understand.

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