Leaders’ Questions.

Glaoim ar Cheannaire an Fhreasúra, an Teachta Kenny.

Tá feabhas ag teacht ar do chuid Gaeilge, a Cheann Comhairle. Tá tú ag déanamh go maith.

It would be remiss of me not to mention the fact that Anne Enright has won the Man Booker Prize for her novel,The Gathering. I am sure the House wishes to recognise this.

I recognise the pragmatism of the Minister for Transport, Deputy Dempsey, in accepting yesterday evening the Fine Gael motion on mandatory breath testing where injuries occur in road accidents. This is realism and good politics. It is good for road users and it is about time it was done. I thank the Minister. Deputy O'Dowd is pleased with his response.

Every year 100,000 drivers take to the roads without insurance. This is at least three times the rate in most European countries. On average, 20 people are killed and approximately 2,000 injured — some seriously — by uninsured drivers every year. This is scandalous. Not only does this visit tragedy and trauma on the families and next of kin of those killed or injured, it also gives rise to a cost of €60 million, that we know of, in claims by drivers who are insured and law abiding. It is time to get tough with this serious matter.

What does the Government intend to do about the rate of uninsured drivers on the roads? Does the Taoiseach agree the time has come for those who use the roads without insurance to be made to pay the price? Does he agree those who are apprehended driving uninsured should have their cars confiscated and sold and the proceeds used for victims' compensation?

I extend warm congratulations from this side of the House to Anne Enright on her marvellous achievement in winning the 2007 Man Booker Prize for fiction. This is an enormous tribute to her.

The Taoiseach's day may come when he writes a work of fiction.

If Deputy Barrett buys it, I will be quite happy.

(Interruptions).

The Minister for Transport, Deputy Dempsey, has announced that existing legislation will be amended to allow for compulsory roadside testing. This is in line with his priorities declared earlier this year. I am glad everyone agrees with that decision.

The report of the European Transport Safety Council and the Government action programme on road safety both refer to the issue of insurance, among others. The dedicated Garda traffic corps is clamping down on this and every other abuse. The corps places 30,000 checkpoints on the roads every month. Measures have been introduced to reduce all road safety abuses. Lack of insurance is one of these. Priority has been given to the Garda traffic corps which has between 850 and 900 members, which number will increase to 1,250. The corps is clamping down extremely hard on all abuses. It confiscates the cars of non-insured drivers. I do not think they are sold off before their owners have a chance to put a case in their defence, but they are confiscated. This is necessary, as it is not acceptable to drive without insurance. While the number of road accident fatalities is declining, statistics from insurance companies, the Department of Transport and independent agencies all show that the figures for injuries and deaths are enormous. Apart from fatalities, road traffic injuries impose a cost on the health service and the insurance industry. This issue was raised some yearsago when we tried to reduce insurancepremiums.

Almost 500,000 penalty point cases have been processed by the Garda computer system since the action of the traffic corps was stepped up. It is the Government's intention to continue with this. The number of road accident fatalities has fallen by more than 10% in recent years and by 25% in the past 12 months. Members will be aware from the figures on road deaths released this week that Ireland is ranked 12th out of 29 countries and has a considerable way to go. I accept that stopping those who take the chance of driving without insurance and seizing their cars is but one measure. However, the main action, to answer Deputy Kenny's question, is the consolidated effort being made by the dedicated traffic corps which is stopping almost 30,000 motorists a month and is closing in on people who are abusing the Road Traffic Acts, including through their failure to have insurance.

I asked the Taoiseach if he would be prepared to send out a clear message to people driving on Irish roads that those caught driving without insurance will have their vehicle confiscated, sold and the proceeds used for victims' compensation and so on. The Taoiseach should send out a clear and tough message to this effect. After all, law abiding drivers are paying €60 million in respect of claims arising from uninsured drivers.

We welcome everybody to this country. According to the Lonely Plant travel group, Ireland is the friendliest nation in the world with the exception of Fiji and Malawi. However, 1,700 crashes on Irish roads last year involved cars registered in Poland and Lithuania. Obviously, persons from those countries and others are welcome here when they contribute to our economy but we have standards that should apply to everybody.

There is growing concern about the large number of drivers from outside the State who retain their domestic registration and renew their insurance policies in their home countries. This, in turn, gives rise to all of the difficulties that ensue when a driver from outside the State is involved in a crash with an Irish driver. This is a new issue in addition to the current loophole which allows foreign registered cars to be re-registered here for two years before any checks in respect of roadworthiness, NCT and so on are required.

Another glaring problem, as pointed out yesterday evening by Deputy O'Dowd, is that of the 400,000 penalty points cases this year, 108,000 of those points cannot be applied because the drivers do not hold Irish driving licences. It is time a clear message was sent out given the carnage on our roads. The regulations in respect of driving, registration and insurance are very clear. We should have no qualms about saying that the regulations and rules apply to everybody, be they from Ireland or elsewhere.

The Taoiseach will be aware that in future an Irish person travelling to another EU country, purchasing a car there and bringing it back to Ireland will be required as an Irish national to have the car undergo an NCT and roadworthiness test within six months. The issue in respect of foreign registered cars not having to do this for two years is causing a problem.

Now that progress is being made in terms of mandatory breathalysing, will the Taoiseach speak to his Minister for Transport to ensure clear rules are set down in respect of driving, insurance and re-registration? These rules should apply to everybody across the board. People should know that if they are caught driving without insurance in this country, their car will be confiscated, sold and the proceeds used for victims' compensation.

As I said earlier, to the best of my knowledge confiscation of a car is one of the actions open to the Garda Síochána. It is not the only action but the legalities of what the Deputy is suggesting would need to be examined. A garda can confiscate a car where an individual has been found to be driving without insurance. I agree with this, subject to the legalities involved.

Has it ever been done?

Yes, I have seen it happen a few times on the roads recently. Gardaí are confiscating cars for different reasons. Obviously, non-nationals were involved in some instances. As Deputy Kenny stated, quite a number of issues arise in respect of the plates being used and so on.

A number of the issues raised, apart from insurance and the clampdown in that regard, are EU related. However, the situation in respect of foreign drivers in this country is no different from that which pertains in respect of an Irish person driving on the Continent with an Irish registration plate. I am told that efforts are being made at EU level to co-ordinate the rules regarding those issues. The Deputy mentioned one of them, namely, testing within a particular period, and it would be sensible for this to happen. An attempt is being made at EU level to harmonise regulations of penalty points in respect of people who drive cars in other jurisdictions. We will have to await the outcome in this regard.

People who drive in this country have the same rights and obligations as Irish citizens who drive on mainland Europe. The point the Deputy is making is whether they should be subject to local laws, rules and so on. There would have to be a European understanding in that regard. I do not believe we could arbitrarily apply a regulation in that regard in this country. The longer a person is allowed to retain a car in a jurisdiction without it undergoing mandatory testing and so on, the longer the system remains open to abuse. One does not have to be an expert to note the high proportion of cheap cars being driven in this jurisdiction. Many people are not worried whether these vehicles are confiscated or not, something of which the Garda is very conscious.

In the meantime, Ireland has complied and continues to comply with the European Transport Safety Council report on EU safety. The Minister for Transport, Deputy Dempsey, will shortly publish a road safety strategy through which we will continue to improve and enhance fairly tough regulations. Some people may not be pleased with many of these regulations. While all of them cannot be implemented within a fixed period, many of them will be introduced in the next few years. We will continue to enhance our road safety. The strategy, which is due to be published in approximately two weeks, is a comprehensive report which outlines the many actions that will be carried out, not overnight, but during a fixed period. In the meantime, we will continue to support the dedicated transport corps which comprises more than 800 gardaí who stop 30,000 drivers a month in respect of issues such as alcohol consumption, performance and so on. These checks are improving our statistics on road safety and we must continue to enforce them. That is the Government's intention.

I join Deputy Kenny and the Taoiseach in congratulating Anne Enright on winning the Man Booker Prize and to express my delight that she has a family connection with Dún Laoghaire.

From the beginning of this week, approximately 4,500 recovering heroin addicts, almost 3,000 of whom reside in Dublin, have had their lives thrown into chaos as a result of the withdrawal of the methadone dispensing service provided to them by pharmacists. These people are, in the main, recovering heroin addicts who have been receiving methadone treatment in the community pharmacy arena. Many of them have been getting their lives together, returning to work and so on. The withdrawal of this service has thrown them back into thead hoc arrangement of drug treatment clinics which brings them back into the same type of environment and company which may have been responsible for their problems in the first instance. Not alone is their health being exposed, but they are being exposed to the possibility of a return to heroin addiction. Despite what is claimed, the decision of pharmacists to withdraw the methadone service appears to be directly connected with the dispute which has been taking place for some time between pharmacists and the Health Service Executive about the method of payment for the dispensing of drugs under the GMS scheme and, to some extent, under the drugs refund scheme. As I understand it, the Health Service Executive has unilaterally decided to cut the margins pharmacists receive for the drugs they dispense under the GMS scheme and the drugs refund scheme. Some pharmacists tell me that the extent of the cut, in respect of some drugs, means they are now required to dispense at either below cost or with a very low margin. In the long term the consequences of this will be to put at risk the independent local pharmacy with which we are all familiar. It will be of huge concern, in time to come, if people are given a prescription from their doctor but there is no local pharmacy, meaning they have to travel to the nearest big town or city for the prescription to be dispensed at one of the big pharmacy chains.

At the heart of the dispute has been the refusal of the Health Service Executive to negotiate margins and the method of payment for drugs with the Irish Pharmaceutical Union, apparently because the Health Service Executive interprets the Competition Act 2002 as prohibiting it from negotiating with the IPU because they are independent businesses and issues arise related to competition. The rows about not negotiating with the IPU and about margins on drugs dispensed by pharmacists have been rumbling on for well over a year. Does the Taoiseach agree that, whatever about the merits of the dispute, it is not right that some of the most vulnerable people in society are made a target and used in a dispute such as this to the extent that their needs and rights are seriously put at risk? Does he agree there is a necessity to return to dispensing methadone in community pharmacies? What can be done to bring that about as quickly as possible? Can the Taoiseach explain how the dispute between the pharmacists and the HSE, which has been rumbling on for so long, has been allowed to come to this pass? What will be done to facilitate discussions between the HSE and the Irish Pharmaceutical Union to settle the outstanding issues relating to the dispensing of methadone and the payment under the drugs scheme?

There are three issues. The first relates to methadone, the second relates to ongoing negotiations between the HSE and the pharmaceutical organisations about prices and the third relates to the legal position in the context of competition law.

On the first issue, this is a dispute between pharmacists and the HSE over the price of drugs, which the former dispense and for which they are reimbursed. The HSE has set a new price which, because of competition law, could not be negotiated. This issue is separate from the level of fees paid to pharmacists under the community drugs schemes, which amounted to almost €300 million last year.

While disputes have to be resolved by negotiation, there is no justification whatever for bringing recovering drug addicts into a dispute, no matter whether it is called a commercial dispute or an industrial relations dispute. The dispute has nothing to do with people who are doing their best to recover from an addiction problem. The HSE has stated there is a significant clinical risk to clients who revert from a methadone maintenance programme to opiate use. In light of this the action of 140 pharmacists to withdraw services from approximately 3,000 methadone patients is totally wrong and the same applies to threats to withdraw from dispensing drugs to medical card holders. It should be noted that this is not an act of the Irish Pharmaceutical Union and I ask those who are doing this to drug addicts to stop immediately. The latter have nothing to do with the dispute in which the pharmacists are engaged and it is a very unfair way of fighting their cause.

On the wider issue, a number of difficulties are involved in the discussions, which are ongoing. The new price arrangements involve revised rates for community and hospital supply. In the existing arrangements for community supply pharmacists enjoy a wholesale margin of 18%, which is being reduced to 8% from next January and to 7% from January 2009. As regards hospital supply, the new interim margin of 5% will apply from 1 January 2008, with further discounts for efficient ordering of supply in the sector. Savings of approximately €100 million per annum are expected, almost all in the area of community supply, which will mean a reduced price base will apply for all medicines dispensed under the various GMS systems.

The pharmacists have arguments and difficulties with this but we do not have time to go into that. I accept the IPU has concerns on behalf of community pharmacists about the implications of the legal advice in respect of their right to negotiate fees within the State. To address these concerns the Minister agreed to the establishment of a process of dialogue, which is chaired by Mr. Bill Shipsey SC, to explore the ways pharmacists' concerns could be addressed, subject to the legal position. The HSE and the departmental negotiating team met with them last week to discuss implementation issues arising from the new wholesale arrangements and both sides have agreed to meet again. They met on 3 October and 11 October, under Mr. Shipsey's chairmanship, and have agreed to continue to engage. Summaries of the HSE's position are in the public domain and an information note has been given to Deputies. The discussions should continue.

The view of the HSE, with which the Government agrees, is that there is considerable room for savings in the overall supply of drugs. The drugs and medicine budget is going up astronomically every year. The figure is enormous and we believe that, using price margins and economies of scale, savings can be achieved. Wholesalers are also involved and have a role to play. As with all industrial relations and supply issues, I could make many arguments if the House had time but the resolution must come from the negotiations.

The legal position can be explained by competition law. Competition law has been examined by the Attorney General and, independently, the HSE and the Irish Pharmaceutical Union. The legal position is based on the Competition Authority view that to deal directly with a large group is to effectively create a cartel, which goes against competition law. The Competition Authority has also made that case in other areas. The legal opinion of the way the Competition Act 2002 is drafted is unanimous and there is no dispute among legal representatives of the parties. Some further examination is taking place but I do not know if anything can be done in that regard. My advice at the moment is to the contrary.

The Taoiseach refers to negotiations and talks which have been initiated under the chairmanship of Bill Shipsey SC and we hope they succeed. However, this problem has arisen because negotiations could not take place in the normal way. It was decided that negotiations could not take place with the IPU because of the provisions of the Competition Act 2002. When the Competition Bill was going through this House in 2002 I do not think any Member anticipated it would be interpreted in such a way as to prevent the negotiations between the HSE and the IPU, which have been required in this case for some time. I do not understand why this has arisen only in the case of pharmacists. Over the course of the past year the Bar Council and the Law Society have negotiated with the State on the levels of legal fees for the criminal legal aid board and the civil legal system and I think it resulted in double digit increases in some cases. There have been negotiations between the HSE and the IMO in respect of general practitioners who are practising on their own. There have been negotiations between the HSE and the dental association on behalf of dentists who are functioning on their own. There have been negotiations between the Department of Agriculture, Fisheries and Food and veterinarians on the various schemes for animal testing. How is it that the Competition Act which does not seem to have caused any problem in preventing negotiations between sole traders in other professions has suddenly given rise to this difficulty in the case of pharmacists alone?

The legal advice is interesting. Will the Taoiseach say who has given it? Is it the advice given to the HSE or has the Attorney General expressed an opinion on the matter? If the Competition Act is so rigid that it is preventing the sensible negotiations that need to take place between the HSE and the IPU, the Government should amend it in a way that would allow negotiations to take place. If a State agency comes to a group of professionals or businesses and states it will cut fees or their margins by half, no matter what the merits of the case might be, they will at least want to talk about it and discuss the implications. We now have a difficulty that recovering heroin addicts cannot get methadone — I appreciate that distinctions are being drawn — but the reason pharmacies are talking about closing down is that they have been flagging a problem for the past year but they have not been able to get to the table to negotiate. That needs to be resolved. By all means, let the discussions chaired by Bill Shipsey go ahead but a method needs to be found, if necessary by changing the Competition Act, to allow the IPU to represent pharmacists in the normal way that business associations or professional bodies represent their members in their dealings with the State.

The dispensing of methadone does not come under the agreement, which is the subject of the dispute. Whatever the merits of the dispute, the 3,000 methadone users should not be affected by it. There are ongoing talks with the HSE. The parties met on 3, 11 and 16 October under the auspices of Mr. Bill Shipsey SC. I do not know whether they can resolve the issue.

The savings on the new wholesale margins are substantial. In the next three or four years the estimated savings will be €260 million on a drugs bill that is rising significantly year on year. As the HSE sees it, in its examination of the issue — the Department of Health and Children and the Government agreed with it — this is not an enormous amount in what is a very lucrative business. We can see what is happening. Three or four years ago I was listening to the argument that pharmacies would be put out of business, but since the last dispute, a further 300 have opened and are, according to the figures I have seen, are doing very well.

Let me explain the legal position. Whatever about its unsatisfactory nature, when the HSE team sought to negotiate the new wholesale margins with the Pharmaceutical Distributors Federation, PDF, which represents full-time wholesalers, it refused to negotiate new margins for community pharmacists because it was its legal advice that it did not have to negotiate them. The HSE also received advice that under section 4 of the Competition Act 2002, it was prevented from negotiating directly with undertakings or associations of undertakings. This applies also to the representative body for pharmacists, the IPU. Deputy Gilmore asked who gave the legal advice. First, the Pharmaceutical Distributors Federation took legal advice. The HSE then sought such advice, as did the Department of Health and Children, which advice concurred with that of the HSE. The Office of the Attorney General and an independent senior counsel have endorsed this advice. They all agree this is the position.

Why does it apply to pharmacists only?