Pharmacy dispute - Sit down and sort out drugs row

PHARMACIST are threatening that in 15 days’ time medical card holders will have to pay for drugs and that they will have to seek refunds from the State unless the Health Services Executive abandons attempts to get them to sign a new, less lucrative contract.

Just as in an a earlier round in this row, when 140 pharmacies in Dublin decided that they would not supply people using methadone in their struggle with heroin addiction, a vulnerable group may become the meat in the sandwich in this dispute over the cost of drugs.

The HSE and the pharmacies are at loggerheads over the HSE plan to cut €€100 million from its drugs bill. HSE analysis has shown that the current medicine wholesale mark-up in Ireland, at 17.66%, is more than double the EU average.

Pharmacists received €1.35 billion for buying and dispensing drugs for the HSE in 2006. Out of more than 1,300 community pharmacies, 540 were paid more than €1m. One firm received more than €4m.

For their part the Irish Pharmacists’ Union have accused the HSE of arrogance, bullying and breaking promises. They have also accused the HSE of being high handed and trying to force this deal through without negotiation or consideration of the consequences for pharmacies, especially smaller, family run ones.

This vocabulary is similar to that used to describe the HSE during negotiations with Irish Dental Association or the Irish Medical Organisation. It is possible of course that these trade unions have been used to getting their own way almost as a matter of course and now, having met sterner opposition than they are used to,begin to feel a cold, reforming wind blow into their comfortable world.

It is also possible that the HSE is a corporate bully, careless with its big stick, deceitful and unconcerned about small family pharmacies competing with chain store pharmacies.

It must be acknowledged that deep unhappiness with HSE methods of negotiation is a recurring theme. Its record on reform and streamlining services for the benefit of those of us who would use them still has tremendous room for improvement.

Both of these positions might be true, maybe even bits of just one. Both of them might be so far off the mark as to represent a dreadful, inaccurate attack on those involved.

But at the end of the day it does not matter half an aspirin. There are a few fundamentals that won’t change: we can’t continue to pay a lot more than the European average mark up for drugs; the pharmacists will supply those drugs and the HSE will save some money.

Three-and-a-half months have passed since methadone users were shamefully used as pawns in this dispute but in that time there has been little if any progress. Indeed, so frustrating and divisive has the process become that significant divisions have opened up between government and Fianna Fáil backbenchers.

At yesterday’s Joint Health and Children Committee, a Fianna Fáil motion, passed unanimously, stated: “That this committee calls on both the HSE and the IPU in the interests of patients and as a matter of urgency to work constructively and agree a formula to resolve this issue.”

In other words let sense prevail, sit down and sort it out and don’t — again — use the weakest people in the system as leverage.