HSE v pharmacists: cry halt to this headlong march over the precipice

MUCH has been said and written about the dispute between the HSE and the pharmacists and not all has been useful or illuminating.

I flatter myself that, as a practising pharmacist for nearly 30 years and someone who has had the honour to serve as minister of state with responsibility for mental health, I might be able to point out some indisputable facts that all parties concerned would do well to remember.

Some consideration of the realities might slow down the headlong march over the precipice.

The most important party in this dispute is that group of patients who need their medicine as soon as possible after they come to the pharmacy from the doctor or the hospital.

Where those patients suffer from any form of mental illness or condition, it is emphatically unacceptable that they might be put in a position whereby they would be unable to fill their prescription. Even the threat of such an eventuality will alarm the vulnerable people concerned and may compound their condition. That cannot be permitted.

Health Minister Mary Harney deregulated pharmacy and we have, as a consequence, approximately 300 new pharmacies. These practices are, for the most part, operated by young pharmacists who have entered freely into a series of agreements with the HSE, financial institutions and pharmaceutical wholesalers. They have signed legal contracts and their primary concern, as far as I can ascertain, is to abide by them while delivering the best possible service to the public.

The HSE — without any consultation whatsoever — has decided to move the goalposts in this arrangement in an attempt effectively to claw back €100 million per annum from the pharmacists. That will be introduced without any semblance of study into its effect on pharmacists’ incomes and, even more interestingly, without any study of its effect on the present satisfactory geographical spread of pharmacies.

In other words, will this clawback challenge the overall viability of some of the rural pharmacies that would be disproportionately dependent on older medical card-holders?

If those pharmacies are heavily reliant on the present pricing arrangements and would not be able to survive in the new circumstances, what is to become of the service they used to offer?

Who will open up pharmacies in rural areas with older populations?

If the changes go ahead as scheduled tomorrow, the implications will be catastrophic.

I understand that the Pharmaceutical Society of Ireland (PSI) is ready to participate in a study aimed at introducing beneficial reforms and one that will rest on a comparison with the systems operated by other countries.

The ministerial appointment of Seán Dorgan to chair the independent body that will report in a few months on all aspects of the pharmaceutical service is also to be warmly welcomed.

The characterisation of pharmacists as an avaricious cartel is wholly inaccurate. The PSI now has a lay majority and all the pharmacists I know welcome the legislation and regulations that govern their profession. Pharmacists are not concerned with featherbedding themselves at the expense of the public purse, but they cannot allow existing arrangements to be overturned on a unilateral whim with the most profound implications for the delivery of a service that all concerned would concede to be very satisfactory in its social and geographic reach. I appeal to all concerned to pause before irreparable damage is inflicted to a system on which some of our most vulnerable people rely.

The welfare of those suffering from any degree of mental illness must be paramount and if that means an end to threats of strike action or limiting hours of service, or the issuing of diktats from the HSE, then that is what must happen.

It must be possible for the Irish Pharmaceutical Union, the PSI, HSE and Department of Health to resolve this in a way that spares those most directly concerned needless stress.

Negotiations conducted in good faith would yield an answer, but acting in a unilateral and pre-emptive fashion can never show us the way forward. I call on the HSE, in the first instance, to announce the suspension of its attempted clawback and give the situation the space that is so badly needed if we are to see the dispute resolved.

Tim O’Malley

Milltown

Ballysimon

Co Limerick