Irish Health Minister Mary Harney has caused a storm by announcing that the government is considering introducing the nation’s first-ever prescription charges.

The Department of Health and Children is considering charging people with medical cards 50 cents per prescribed item, as a way of saving money and curbing excessive prescription drug use, the Minister has revealed, but opponents of the plan say it would target those least able to pay.

The move, which is being considered as part of government efforts to save more than 1 billion euros from the nation’s annual 16 billion-euro health budget, would affect around 1.4 million people and raise around 20.5 million euros a year, it is estimated.

The Department is looking at “everything” in the health service as it seeks to make savings of over 1 billion euros in 2010, Ms Harney said on Sunday, adding: “we are looking at prescription charges, for example, which we’ve never had in Ireland before.”

Speaking on RTE television, she said the government has to raise money and discourage over-prescribing and over-use of medicines. One in six people who receive their medications through the General Medical Services (GMS) Scheme are prescribed 10 or more items, even though “very few” people would need so many, and that is not good for patient safety, she said.

According to local reports, the initial Department proposal was for a charge of 2.50 euros per prescription item, which would have raised 100 million euros a year, but this was considered too controversial.

The Irish Pharmacy Union (IPU) has expressed concern at the proposed charges, warning that they could lead to medical card-holders failing to take medicines which are essential and ending up in hospital. The Union says it has recommended to the government that the issue of medicines wastage should be tackling by pharmacists conducting medicine use reviews.

The Society of St Vincent de Paul, which exists to fight poverty and is Ireland’s largest voluntary charitable organisation, has also condemned the proposals and says it supports the wider use of generic drugs.

However, generics are substantially more expensive in Ireland than in the UK, and tackling this issue is central to proposals forward yesterday (November 16) by the Irish Medical Organisation (IMO). As well as reducing the prices of generics, the IMO calls on Ms Harney to move quickly to establish reference pricing, recommends the establishment of an all-party working group to “oversee the achievement of economies in drug costs through generic prescribing and other measures” and the setting-up of prescription support teams to work at community level with general practitioners (GPs) and hospital doctors. Taken together, these proposals could cut 300 million euros off Ireland’s drugs bill, says the IMO.

- Speaking on RTE television after Ms Harney made her comments, Ireland’s Taoiseach (prime minister), Brian Cowen, said that a prescription charge was just one of the options being considered for inclusion in December’s budget. Nevertheless, he added: “we have to find ways to deal with rising drug costs.”

Health care currently accounts for 27% of total government spending each year in Ireland.