Michael Colreavy
Ceist:8Deputy Michael Colreavy asked the Minister for Health if he will fulfil his commitment to abolish prescription charges for medical card patients; and if he will make a statement on the matter. [24201/12]
Amharc ar fhreagraWednesday, 16 May 2012
Ceisteanna (9)
Freagraí ó Béal (19 píosaí cainte)
Medical cardholders are required to pay a 50 cent charge for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €10 per month for each person or family. Charges are not payable in respect of items supplied under the long-term illness scheme. Prescription charges do not apply to children in the care of the HSE or to methadone supplied to patients participating in the methadone treatment scheme.
Prescription charges result in savings to the HSE of approximately €27 million annually. I regret that, due to the current financial climate, I am not in a position to remove the 50 cent prescription charge, one of my goals on entering office. However, despite the very difficult budgetary situation, the Government has ruled out an increase in prescription charges.
At the time prescription charges for medical cardholders were introduced by the then Minister, Mary Harney, in 2010, the then Fine Gael spokesperson on health - I wonder who that would have been - described them as "aimed at the most vulnerable, sickest and weakest in our society". He pointed to international research showing that "any disincentive for people to take medicine should be avoided as certain patients will inevitable end up in hospital." He went on to point out that the cost of a single day in hospital would wipe out any supposed savings from the charges for prescriptions.
What has changed with the Minister? Why has his response changed from the position he articulated quite correctly in 2010? Why are we seeing the continuation of prescription charges for medical cardholders?
Thank you, Deputy.
The Government's policy was to repeal the imposition of prescription charges but it has never been given effect. Recently, I presented a Bill to repeal this charge to the respective office in the Oireachtas for consideration but it was rejected on the basis that the repeal of a charge by an Opposition Deputy would represent a charge on the Exchequer. Every obstacle is put in our way as Opposition voices to try to have this outrageous charge not only addressed but reversed.
Thank you, Deputy. I must call the Minister.
I thought my answer was clear on how the situation had changed. However, the old saying comes to mind, "There are none so blind as those who will not see and none so deaf as those who will not listen." The reality is that not alone were the coffers empty when we arrived in government but there was a stack of IOUs in them as well. The money is not there to do what I wanted to, as already stated in my original reply. It was also one of the first actions I wanted to take on first becoming Minister. I still believe any barrier to someone taking their medicines is to be avoided.
There are many other ways, which we are investigating, for reducing the drugs bill and the amount of drugs prescribed, which are sometimes hoarded by people of which I had personal experience as a GP. This can be done with the aid of pharmacists monitoring what is prescribed and double-checking whether a person has used his or her full amount of medication. Some medications are prescribed on a PRN, pro re nata, basis. Much work can be done in this regard.
It is clear with the difficult financial situation in which this country finds itself and with €2.5 billion gone out of the €16 billion health budget in the past three years, we are not able to do many of the things we would like to do. That does not mean that sometime in the future we will not be able to achieve that goal of repealing these charges.
The Minister knows best about those who do not want to hear because he does not want to hear what he said himself when he was in opposition. He will be reminded of it time and again.
The Minister would have the support of all voices in this House if he proceeded with Mary Harney's promise of reference pricing and generic substitution. Legislation was promised to address that. These are critical points. For all her failures, which were legion, at least she identified an area that needed to be addressed and which we could support. Although this Bill was promised, it has yet to be published. What is happening in the Minister's Department that there is not significant progress at least to signal the intent to bring in this legislation?
Thank you, Deputy. I must call the Minister.
Will the Minister address that matter? Will the Minister indicate to the House his intention to repeal this charge on medical cardholders that is an impediment to access to essential medication?
I have just signalled very clearly that in the future I hope to be able to introduce the repeal of these charges as the economy improves and we make savings in health as we have done to date. Last year, through the new clinical programmes and the special delivery unit in conjunction with front-line services, we saved 70,000 bed days at a value of €63 million to the State. That money has been reinvested in health to ensure more patients can be treated more quickly. Similarly, in a pilot money-follows-the-patient scheme in orthopaedics, it was insisted patients be admitted on the day of the procedure rather than the night before, as long as there was no co-existing morbidity. We saved €6 million in this move. We hope to do much better this year.
The costs of drugs are a major issue, as was addressed by my colleague, Deputy Shortall, earlier. It remains a bone of contention between us and the pharmaceutical industry. Nonetheless, the industry has to come to the party. There is a limited pot. If we have to make room for new drugs, then older drugs have to fall in price to accommodate that. There must be some risk-sharing by the pharmaceutical industry and more involvement with patients and patient groups in this area. It has already been successfully done by the Irish Haemophilia Society, in conjunction with the Department, in acquiring blood products. Through the pressure it brought to bear considerable savings were ensured.
Drug reference pricing legislation is a key priority and it is out for consultation. It has elicited an alarmed response from the pharmaceutical industry. The industry must acknowledge, however, this country can ill afford, much less than many other countries, the high prices we are charged for drugs.
The Minister made a statement some time ago about the abolition of prescription charges. The first parliamentary question I tabled to this Government was to the Minister for Finance. He informed me Government members were fully aware and briefed in advance of the programme for Government of the difficult circumstances in every Department. Yet, the Minister for Health still made a statement on the abolition of the charges after taking up office. He looked into the cupboards, knew they were bare, saw the IOUs but still made the promise. It is not factually correct for the Minister to claim he was unaware of the difficulties. He was fully aware of them and he still insisted on making the commitment to abolish the prescription charges.
As we are having a little history lesson, may I remind the Deputy that I was only in the door as Minister for Health when I gave that interview on prescription charges and that I had not had the opportunity to examine every cupboard? I certainly was not given the opportunity to check behind all the radiators where certain other reports had been lost. The Deputy might ask his leader about those.
I stand and acknowledge fully that I sought to get rid of the prescription charge because I believed it could have been a barrier to some people maintaining medical care. It may have been to their detriment and at greater cost to the State. I hold that belief still but I am not in a position to repeal the charge because I do not have the extra €27 million. I need not remind the Deputy of the reasons for this.
The Minister maintained it would be budget neutral.
It is not budget neutral at all. It brings in €27 million per annum, and I would dearly love to find that money elsewhere. I will continue to seek it elsewhere so that I can fulfil that promise. I, along with many other people in the country, was not aware of the depth of the destruction the Deputy's Government wreaked on the country until we got a complete look at what was going on in individual Departments. One might have an overview, but it is only when we get to the nitty-gritty of each Department that we can see the true extent of the damage and disaster that resulted from the Fianna Fáil and Progressive Democrats Government.
I call the next question in the name of Deputy Brendan Smith.
What about the Greens?
Exactly. Who are the Greens?
What about the builders?