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Seanad Éireann debate -
Wednesday, 1 Nov 1995

Vol. 145 No. 1

Irish Medicines Board Bill, 1995: Committee Stage (Resumed).

Question again proposed: "That section 4 stand part of the Bill."

This is a very sad moment. I had great affection for Deputy Lenihan. He became ill here one day and when I went to see him later he said he thought that an angel had come to see him. That was very kind and he was always so polite.

To return to the Bill, if the board has to supervise the premises of the Blood Transfusion Service Board as well as the collection of blood it is a very onerous task. They will be well aware of how serious that will be for them. If it would be of help, I will look up the information I have regarding the confidential line and will bring it to the Minister's attention. The fact that a phone provided immediate communication to deal with the problem was good and increased the reporting of reactions. While one deals with serious reactions, the summation of less serious reactions might show a pattern which it is essential the board should be aware of. What the Minister has said will be very useful.

I beg your indulgence to convey my sympathy to the family of Brian Lenihan.

On the Bill, I would be grateful for the information that Senator Henry mentioned. Senator Doyle raised the issue of inspectors which will become clearer in the context of the consultancy taking place. It is the firm intention of the Government that adequate staff will be provided and I will revert to the Deputy on that matter when the situation becomes clearer. While the recommendations of the consultancy are not to hand, I will respond when I have them.

Question put and agreed to.
SECTION 5.
Question proposed: "That section 5 stand part of the Bill."

Under this section extra function can be given to the board, in particular as they might apply following decisions applicable to the Department of Agriculture, Food and Forestry. I presume this is as a result of some EU directives, and perhaps the Minister could elaborate on that. The over use of antibiotics in livestock is an area of concern to the public. It has been debated by local authorities and health boards as well as on the floor of the House. People fear their health can be put at risk because of the over use of antibiotics in the treatment of animal disease, particularly milk problems in dairy cattle. The use of angel dust is also a matter of concern. Perhaps the Minister of State would explain the situation regarding the danger to human health arising from livestock being treated with antibiotics and other substances.

This section allows the Minister to confer additional functions on the board and I am concerned that such additional functions will overstretch the personnel of the board. Since safety is a priority of the Irish Medicines Board, can the Minister guarantee that any functions given to the board under this section will not undermine the safety aspect in any way?

As regards the issue raised by Senator Finneran, the Animal Remedies Act, 1993, is the relevant legislation dealing with prohibited substances.Heretofore the Minister for Agriculture, Food and Forestry, through the resources available to him or her, made recommendations to the National Drugs Advisory Board in relation to particular pharmaceuticals used in the treatment of animals. The National Drugs Advisory Board has been the licensing authority for veterinary pharmaceuticals but that situation is about to change. The section enables the Minister, at any time in the future, to confer additional functions on the board should the need arise. For example, developments associated with the European Agency for the Evaluation of Medicinal Products may involve additional responsibilities for the board. It is in that context that this section was conceived. However, I assure Senators that the primary function of the board is to ensure product safety and public health.

Question put and agreed to.
SECTION 6.
Question proposed: "That section 6 stand part of the Bill."

Section 6 (1) states:

The Minister shall appoint a member of the board to be chairperson of the board.

I question whether the Minister should appoint the board and I will speak about that in the next section. I do not see why the Minister should appoint a member of the board to be the chairperson.Why not leave it to the board to elect its own chairperson? If the Minister has the authority to appoint the board, does he not believe the board has the ability to elect its own chairperson? Not only does he appoint the entire board but also the chairperson, thus denying the right of board members to elect their own chairperson. That is taking the matter too far.

This is a standard provision enabling the Minister to appoint the chairperson of the board. It will be noted that section 6 (5) states:

The chairperson of the board shall be paid such remuneration (if any) and such allowances for expenses as the Minister, with the consent of the Minister for Finance, may from time to time determine.

This provision is standard practice and it is in the legislation in that context.

Question put and agreed to.
SECTION 7.
Question proposed: "That section 7 stand part of the Bill."

Allowing for the standard practice which the Minister spoke about in relation to the selection of the chairperson of the board and given current thinking and, to some extent, Government statements, is the Minister not open to making political appointments? Section 6 states that the Minister shall appoint the chairman of the board, while this section states that he shall appoint all the members to the board. This is a closed shop which will involve political patronage. The Minister will appoint nominees who, if we go by past experiences, have a political allegiance to his party or to a Government party. That is something which certain members of the Government have spoken out against recently.

How can the Minister reconcile recent statements by the Government on appointments to boards with the provision in section 7 which states: "The Minister shall, as soon as may be after the establishment day, appoint persons to be members of the board."? If we do not want political involvement, then the Minister should not appoint members to the board, otherwise he is leaving himself open to the charge that he is appointing people of a political persuasion.That may not be so in all cases but that charge could be made. Surely in a case like the Irish Medicines Board the Minister should keep out of it and leave it to the professions and the interests involved.

The board will be independent and should comprise the medical and veterinary professions and interests, including the pharmaceutical industry and chemists, who are involved in the industrial, commercial and professional side of human and veterinary medicine. The Minister is leaving himself open to the charge that his appointments are political.

I presume these provisions are not unprecedented in terms of appointments to boards. In an ideal world I would agree with Senator Finneran, but I suspect we will be waiting some time before we achieve that. I have specific observation in relation to section 7 (6) which states:

A member of the Board may at any time be removed from membership of the Board by the Minister if, in the Minister's opinion, the member has become incapable through ill-health of performing his or her functions, or has committed stated misbehaviour, or his or her removal appears to the Minister to be necessary for the effective performance by the Board of its functions.

I presume the Minister's opinion on ill-health would need to be backed by professional advice and that stated misbehaviour would extend beyond the Minister's perception of what that constitutes because there could be elasticity of perception on these matters. The final provision which states, "His or her removal appears to the Minister to be necessary for the effective performance by the Board of its functions", seems to introduce a potentially arbitrary element not subject to the controls the phraseology of the two previous justifications requires.

I would like it to state that it appears to the board to be necessary rather than it appears to the Minister. If the board is to be independent — section 3 (3) states that it is to be independent "subject to the provisions of this Act"— and if any member can be removed at any time by the Minister, including presumably the chairperson, simply for this particular reason, then the Minister is retaining excessive authority in that area. I would prefer the question of the possible removal of a member of the board left to the board itself which after all would see the performance of a colleague in board circumstances. I find that provision difficult to justify even accepting the limits imposed on us by the inherited conventions of our political culture.

Senator Lee made a good point because the Minister could remove the entire board if it did not do what he wanted by saying members were ill or behaving badly. What the Minister considers the effective performance of the board may not be what we consider the effective performance. The board has a protective function on behalf of the public.

The appointment of boards and the method by which that is done invariably gives rise to this type of debate. To some extent, it depends on the side of the House one is on at the time.

Transparency.

We should not judge the board before it is appointed but when we see its personnel. This will be a smaller board than the National Drugs Advisory Board which will consist of nine people. I am not convinced — I stated this in relation to other legislation in the last Administration — that if we decide to make nominations from particular constituent bodies we get the best people. The Minister of the day should have the method available to him or her to appoint the best people available.

Given the importance of this board to many aspects of our health services and to the health and safety of the public, I find it difficult to conceive that a Minister from any party would appoint people to the board who would not be capable of carrying out their functions. As time goes by I become less convinced that the nominations option would yield the best people. The bias in this board is in the area of management and streamlining activities in terms of processing and granting licences.

There will always be exposure to charges of political patronage — that goes with the territory. Irrespective of what Government is in power that type of allegation can be made. We should wait until the board is appointed to see if it carries out the duties and functions laid out in the Bill. The provision which enables the Minister to remove a board member because they do not perform their functions is an arbitrary power in terms of how Senator Lee presented it. However, in such a board it is difficult to conceive that a Minister would use that power in a frivolous way. It can happen with boards, committees and even political parties that certain individuals need to be disciplined and to be removed.

The person with primary responsibility in the State for the health services should also have the powers to exercise judgement in dealing with situations which can arise where important State boards may have a member or members who are not contributing and preventing the proper functions being carried out. I am not sure that a member's peers deciding that he or she should be removed from the board is a good idea because, by its nature, that would be divisive and could cause tensions which would prevent the board from getting on with the job.

I do not envisage that the powers would ever be used in a frivolous way but it is necessary to have that protection for the stated reasons of misbehaviour, health or generally not contributing and becoming a negative element of a very important board.

The Minister made a very good case, generally. There is no perfect system of appointments or disappointments——

Or even replacements.

Lapses into clarity are forgiven. The Minister has total power of appointment so if the same Minister chooses to remove somebody on very general grounds then, in a sense, he or she is passing a vote of no confidence in their original decision. If there is a change of Government and the new Minister wants to put somebody else on the board, the permission which this clause allows seems too general. While I obviously take the point about ill health and misbehaviour, on balance and allowing for the valid points of judgement made by the Minister, it would have been preferable to have the board rather than the Minister as the arbiter of the quality of performance of its colleagues in those circumstances.

I do not want to continue with this because, to some extent, the Minister is correct when he says that it depends on which side of the House one is on as a Bill goes through. However, the Minister does seem to have more power under this section than he should have. He said that Ministers do not remove board members but I disagree as members have recently been removed and replaced by a particular Minister which has been a matter of grave public concern. Some of those removals and replacements were carried out in a fairly arbitrary fashion, depending on which side of the boundary one was on.

Section 7 states that the Minister can remove a member who has become incapable through illness or whose removal "appears to the Minister to be necessary for the effective performance by the board of its functions". I do not know what he means by that. Illness would obviously require a medical opinion. However, the Minister could say that he was removing a member or a board because they were a sick, political lot. He does not have to give any reason apart from the belief that they are not carrying out their work in the interest of the performance of the board's functions.

Question put and agreed to.
SECTION 8.

I wish to announce a correction to the printed list of amendments. The second amendment should be numbered "2" rather than "1". Amendments Nos. 3 and 4 are related to amendment No. 2 and all may be discussed together.

I move amendment No. 2:

In page 8, after line 44, to add the following subsection:

"(12) The Board shall ensure that all applications are processed as speedily as possible and shall put in place an independent appeals procedure where applicants can raise matters relating to delays and any refusals of applications.".

Amendments Nos. 2 and 3 essentially seek to put in place an appeals procedure against decisions of the board. I draw attention to the fact that, under the provisions of the Bill, the board cannot refuse any licence unless it has first sought and considered the advice of an appropriate advisory committee, so that the board cannot act unilaterally in refusing to grant a licence. In any event, there is at present a case before the High Court seeking a judicial review regarding a decision to refuse to grant a product authorisation. Among the issues raised in the case before the court was the lack of an appeals mechanism under existing regulations. The judgement of the court is still awaited but is likely to be given during the present term.

Obviously, there is considerable merit in the proposal to seek to provide an appeals procedure. However, I do not believe it is either appropriate or necessary to provide for such a procedure in the Bill. On the contrary, it would be more appropriate for the question of an appeals procedure to be dealt with in the context of the Medicinal Preparations (Licensing, Advertising and Sales) Regulations, 1984, which set out in detail the requirements and procedures for licensing medicines. The regulations will require amending to enable the board to assume the role of licensing authority and the question of providing an appeals procedure will be examined in the context of the amending regulations.

At the same time, regard will be given to the outcome of the case at present before the High Court and any particular issues which the court may identify as requiring attention. I agree that the board should take all possible steps to ensure that applications are processed as speedily as possible but I do not believe that it is necessary to make specific provision in the Bill relating to this. The board will be required by section 20 to carry out an annual examination to ensure it is operating efficiently and economically. At the same time, it will also be required to seek to comply with the requirements of EC Directive 65/65 which stipulates that applications should be processed within 210 days.

The requirements, of course, operate on a "stop the clock" basis. In this context, it is important to note that quite often in the past there were delays where incomplete applications were submitted or where companies took a considerable length of time to deal with the issues raised by the board or its assessors. While I agree that the board should seek to deal with applications as speedily as possible it cannot sacrifice questions of safety or public health considerations which, as I am sure Senators will agree, must at all times be the primary consideration.

Therefore, I do not accept the need for the amendment as proposed, but agree to look at the question of an appeals procedure when amending the regulations.

In relation to amendment No. 4, section 13 is an enabling section whereby the Minister may make regulations for the payment of fees in respect of matters arising out of licensing medicines. It is not appropriate that the section would set out the specific details proposed in the amendment. That is more appropriate to the regulations which will set out the fees and the circumstances in which they will be payable. As Senators are aware, the Minister will be required to lay the regulations before the Houses for approval. At the same time I recognise that the specific proposal in the amendment merits serious and constructive consideration and shall be examined in the drawing up of the regulations.

I want to clarify that the three amendments may be debated now.

Acting Chairman

That is correct.

What is the position when we come to them at a later stage?

Acting Chairman

They cannot be discussed but a decision can be taken on them.

It is important that we have a proper appeals system. The current case would not be before the High Court if there was an appeals system. This matter was discussed in the Dáil and the Minister gave certain commitments regarding regulations. I said to the Minister on Second Stage that, unless I saw those regulations, I would put down certain amendments. There is a great worry about both refusals and delays. It is not sufficient to refer the matter back to an advisory committee or deal with it through regulations.

The law should make exact provision for these situations. It should provide a procedure to deal with delays and another to deal with refusals. They are both serious matters and should be dealt with in this legislation. It is the responsibility of Government to bring forward legislation to deal with those situations. It has been brought to my attention that delay can be a serious matter.

I do not question the bona fides of this Minister but Ministers come and go. We cannot decide the exact contents of the regulations but are dependent on the bona fides of a Minister. I question whether it is appropriate for this Bill to go through this House without provision for proper procedures in a number of areas. These include an independent procedure whereby delays and refusals of applications can be raised as well as a definite appeals procedure as regards appeals.

The other relevant matter is fees. I appreciate the Minister's view that it is an enabling section; he said it would be inappropriate to include detail in an enabling section. How will this board be financed other than by fees? Section 15 provides that the Minister may give a grant but, apart from that, this board's activities will be financed by fees. The Minister said there may be an opportunity to deal with this in the event of litigation. Senator Henry and I attempted to move an amendment which was ruled out of order and the Minister said the matter could be dealt with under section 15.

The board's only income will be from fees. It will, therefore, raise its own income. If the board becomes strapped for cash, the easy option will be to raise the fees. Some pharmaceutical companies can absorb those fees but small companies cannot. Will they fall by the wayside?I proposed these amendments with a view to protecting those companies.They are practical amendments which should be part of the Bill. We have a responsibility to pass legislation which addresses all issues and regulations are not suitable on this occasion, particularly in light of what is happening in the High Court.

Senator Finneran raised pertinent points which deserve a reasoned refutation, if they can be refuted. We did not address adequately the issue of the powers of the board in terms of staff appointments, the size of staff and so on. This would be partly dependent on its income which must come in large measure from fees. The board has a powerful incentive in certain respects to charge whatever the traffic will bear in terms of fees and that could lead to the undesirable situation sketched by Senator Finneran. The relationship between fees and board activity should be teased out further.

The principle of appeal against any State or public board decision should be part of legislation anyway. Does the Ombudsman have any role to play in situations like this? Can one appeal to the Ombudsman on issues relating to delays and refusals of applications? Are there existing powers which allow appeals to be made? If not, there is a strong reason for looking carefully at these amendments.

Senator Finneran and Senator Lee made good points regarding delays and fees. I mentioned another difficulty on Second Stage. One may have a drug which is useful only to a small number of patients. Where there is a standard fee, there is little reason a major pharmaceutical firm should bother to get a licence for the drug in a country with such a small population.

I recognise that the amount of information sent in by companies often is not adequate to enable the board to proceed with the authorisation of a product.However, there seems to be an internal as well as external delay factor affecting the current board. This is not just hard on the pharmaceutical company; it is also extraordinarily hard on patients if it involves a particularly useful drug.

This is an important area. In response to Senator Finneran, regulations are law and emanate from the enabling sections of legislation. Any regulations brought in under this legislation and not annulled by the Oireachtas are law. There has only been one refusal in the history of the National Drugs Advisory Board and that is the case currently before the High Court. The path towards which companies are more usually inclined is to withdraw an application where it seems it could be refused because no company wants a refusal.

Especially if it did not have an appeals procedure.

I gave an undertaking on Committee Stage in the other House that I would address this issue by way of regulation and this was found to be acceptable. That which is brought into effect by way of regulation is still law. It is also inappropriate to have the detail of an appeals procedure contained in the legislation, but the commitment given by me here will be honoured.

With regard to two aspects of the fees, the first, which I addressed on Second Stage, was in respect of a product that would not have a great demand in terms of its usage. There is a system at present in place where the licensing fee with the NDAB is one-twentieth of the general fee; I have no doubt this will continue in the context of the new board. I would, therefore, ask Senators to take on board that, in the first instance, the regulations will be brought before the Oireachtas, and the Seanad and the Dáil will have the right to reject those regulations if they are seen to be inappropriate or do not cover the given situation.

It has been agreed to adjourn the House so that we may have an opportunity to pay our respects to the late Deputy Brian Lenihan.

Progress reported; Committee to sit again.
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