Prescription charges 'disgraceful and target the least well off' – Ó Caoláin
Sinn Féin Dáil leader and Health & Children spokesperson Caoimhghín Ó Caoláin described the Prescription Charges Bill as “a disgraceful piece of legislation that targets the least well off in Irish society”. He said there was “not a bleat” from the Fianna Fáil backbenchers about these unjust charges. Speaking against the Bill in the Dáil, Deputy Ó Caoláin said:
“The most dishonest thing about this Bill is where the actual fees are cited. It is a smokescreen, a device to get the Bill passed. When Government representatives are challenged their main argument in favour of these charges will be: ‘It’s only 50 cents, it’s only €10.’
“But that’s pure deception because in Section 1 the Bill empowers the Minister to make regulations to vary the charges. We know very well that this Minister and future Ministers will increase the prescription charges for medical card holders.
“The Fianna Fáil backbenchers have been much concerned lately about hounds and stags and hares. But it seems that last night the sheep-dog from Clara barked at them and the sheep are now being herded exactly where he wants them to go. There’s not a bleat out of them about this Bill.
“Make no mistake, any Deputy who supports this Bill is opening the way for higher prescription charges in the years to come.
“Instead of making real savings, instead of targeting the profiteers in the drugs industry, the Government has once again gone for the easy targets – the elderly, the infirm, low income families with children. It is shameful.” ENDS
Full text follows
Health (Amendment) (No. 2) Bill 2010
Prescription Charges Bill
Caoimhghín Ó Caoláin TD
Sinn Féin Dáil leader & Health & Children spokesperson
I move the amendment in my name:
That Dáil Éireann declines to give the Bill a Second Reading as prescription charges represent an unjust imposition on medical card holders and undermine the General Medical Services Scheme.
We in Sinn Féin totally oppose this Bill which enables the Minister for Health & Children to impose prescription charges on medical card holders. It is a disgraceful piece of legislation that targets the least well off in Irish society.
It is also a sneaky and dishonest Bill.
It was initially signalled by the Minister for Health & Children and listed as the Prescription Charges Bill. This was changed to the Health (Amendment) (No. 2) Bill in the vain hope of taking the bad look off it.
The legislation sets a charge of 50 cents per item up to a maximum of €10 per month and the Bill has been sold politically and in the media on the basis that the charges are small.
The most dishonest thing about this Bill is where the actual fees are cited. It is a smokescreen, a device to get the Bill passed. When Government representatives are challenged their main argument in favour of these charges will be: “It’s only 50 cents, it’s only €10.”
But that’s pure deception because in Section 1 the Bill empowers the Minister to make regulations to vary the charges. We know very well that this Minister and future Ministers will increase the prescription charges for medical card holders.
At the end of last year it was leaked to the media – deliberately perhaps – that the Minister’s officials were seeking a charge of €2.50 per prescription. This was after Colm McCarthy recommended a €5 flat fee for every prescription in his notorious Bord Snip report. I might add in passing that Mr. McCarthy’s prescription for the ailing Irish economy was a strong dose of deadly poison. The Government deserves no credit for prescribing a slightly lesser dose - but deadly poison nonetheless.
On 19 November last year Minister Harney addressed a body much in the news lately – the Fianna Fáil Parliamentary Party. She floated the 50 cent prescription charge and it was reported afterwards that Fianna Fáil TDs and Senators supported the proposal. Only one TD was reported as expressing concern and he hit the nail on the head when he said he was worried that the charge could be increased in future years.
But Minister Harney saved the day because, we were told in a newspaper report, “observers said Ms Harney made clear that no final decision had been taken”. And so the Cabinet was saved from rebellion in the ranks once again. Then came the Budget with its savage cuts to public services, including health, and its confirmation that prescription charges would indeed be imposed. Did we hear the faintest protest from the ranks of the Fianna Fáil Parliamentary Party? Not a bit of it.
After all the talk of rebellion in the Fianna Fáil Parliamentary Party in recent weeks where are they when this Bill comes before the Dáil?
Is there even one of them to stand up for the people who are being penalised by the prescription charges provided for in this Bill?
The backbenchers have been much concerned lately about hounds and stags and hares. But it seems that last night the sheep-dog from Clara barked at them and the sheep are now being herded exactly where he wants them to go. There’s not a bleat out of them about this Bill.
Make no mistake, any Deputy who supports this Bill is opening the way for higher prescription charges in the years to come.
This Bill, therefore, undermines the General Medical Services Scheme in a fundamental way. Access to essential medication free of charge has always been a corner-stone of the medical card scheme. It has lifted a potentially huge financial burden from people on low incomes, especially families with young children.
As well as being penalised financially people with medical cards are being scape-goated for the high cost of medicines in this State.
We all agree that the cost of medicines to the State and to individuals is too high. We all acknowledge that there is wastage and over-prescription of medicines. We all agree that measures must be undertaken to address these problems. But the very last way to address this is to punish those who are least able to pay.
I agree with Age Action when they state:
“Over-prescribing and inappropriate prescribing is a problem in Ireland but the Minister needs to address this issue with the doctors who write the prescriptions, rather than hitting their patients. The patient is not the person writing the prescription so penalising them will do little to change prescribing practices.”
For many older people on a State pension who are reliant on medication this Bill will mean an extra annual burden of €120 each, initially, and an as yet unknown higher amount when the Minister and/or her successors inevitably increase the charges.
These prescription charges on low income individuals and families come in the wake of the abolition of the social welfare Christmas bonus and the reduction in social welfare payments generally.
And that’s only on the payment side. We are seeing services for people on medical cards and for all who rely on the public health system being reduced on a weekly basis. Dental treatment for medical card holders has been confined to what are called emergencies – with the HSE failing to state what emergencies mean in the context of dental treatment.
Public hospitals are in deeper crisis than ever. Waiting lists and queues are worsening. The promised primary care network has not been delivered. And now we have this disgraceful Bill.
The Government claims that the purpose of this legislation is to make savings and to reduce the State’s drugs bill. For years we in Sinn Féin and others have been calling for greater use of generic drugs and for control of the gross profiteering by pharmaceutical manufacturers and distributors. The Government and successive Minister for Health & Children from 1997 failed to act.
Very belatedly the Minister for Health & Children has moved on the issue of generic substitution. She has also promised to bring in a Reference Pricing Bill. But that bill has not been published. Instead she has rushed in with this legislation to penalise the least well off for a problem not of their making.
As I have stated, there is widespread agreement that the cost of medicines to the State needs to be reduced but it has already been shown that huge savings can be made without imposing prescription charges. Last February an agreement between drugs manufacturers and the Minister for Health & Children made projected savings of €94 million in a full year.
Add to this the further savings that will be made through the use of generic drugs and reference pricing and set that against the estimated €20.5 million that will be raised by these charges. These charges are totally unnecessary from a budgetary point of view, as well as being unjust and unfair.
We have been accused of not coming up with alternative proposals. But we have indeed come forward with such proposals.
In our Pre-Budget 2010 submission ‘The Road to Recovery’ Sinn Féin proposed measures to reduce the cost of medicines in our health system, including establishing State wholesale distribution of drugs. Based on figures provided to us by the Department of Finance, those measures would have saved €200 million, nearly ten times what will allegedly be raised by prescription charges. Ending the notorious co-location scheme would save €100 million in 2010, nearly five times the revenue from the charges, and €400 million over seven years.
Instead of making real savings, instead of targeting the profiteers in the drugs industry, the Government has once again gone for the easy targets – the elderly, the infirm, low income families with children. It is shameful.
Even at this late stage we call on the Government to withdraw the Bill. If it does not do so we call on every Deputy with a conscience to vote against this Bill. Let us see the Fianna Fáil backbenchers find a backbone on a real issue, one that affects over 1.3 million medical card holders in this State. Reject this Bill.