Darragh O’Loughlin: Covid-19 crisis provides a chance to improve patient outcomes

The mass production of penicillin was enabled after spores of it were found growing on an old melon. Fortunately, the discovery was not made in Ireland or it may well have wound up in the bin, writes Darragh O'Loughlin
Darragh O’Loughlin: Covid-19 crisis provides a chance to improve patient outcomes
Some of the changes introduced during the Covid-19 lockdown, like e-prescriptions, should remain in place, says Darragh O'Loughlin, President of the Irish Pharmacy Union. Picture: Ray Ryan

The mass production of penicillin was enabled after spores of it were found growing on an old melon. Fortunately, the discovery was not made in Ireland or it may well have wound up in the bin, writes Darragh O'Loughlin


There is a theory that war has saved more lives than it has taken. The proposers point to the many advances in medical science brought about during times of conflict.

Those of us on the modern frontline of 21st century healthcare can scarcely imagine our jobs without some of these advancements. The tragedy of the Great War led to the perfecting of techniques for collecting blood for transfusions. Orthopaedic surgery owes much of its progress to military doctors such as Dr Sterling Burnell who pioneered hand surgery during World War 2.

As a pharmacist, I cannot conceive of a world without the original miracle drug: penicillin. It, too, first became a mainstay in healthcare during World War 2. Since then, it has saved more than 80 million lives.

It is an impossible theory to test and no one would advocate for a war to save lives.

However, there is an important learning and that is to never waste a good crisis.

Since the start of the Covid-19 pandemic, our government and others around the world have scrambled. In Ireland, they have done well. Tragic as each death has been, without swift action, the number of tragedies could have been far higher.

We must learn lessons too. That process is already starting with the work of the Oireachtas Covid-19 response committee. While learning from mistakes is important, we must pay equal attention to what we got right.

During that scramble, more change was delivered in two weeks than many would have thought possible in two terms of Government. This included utilising private hospitals for public care, introducing rent freezes, the provision of hotel accommodation for many homeless people and facilitating the first ever video enabled remote sitting of the Supreme Court.

As members of the new Government get used to their new surroundings, one message they need to hear is not to let the Covid-19 pandemic crisis go to waste. We need to learn from what we got right. Temporary changes that are working must be kept in place. We must not go back.

In the piece of the puzzle that is medicine supply, changes were made to ensure a continuity of care for patients, led by interaction with their pharmacist. Prescriptions, which are usually only valid for six months, have been extended to nine months. 

There were changes, too, in the way prescriptions can be repeated to take account of patients struggling to access their doctors. In these cases, where it is the professional and clinical judgement of the pharmacist that it is safe, appropriate and necessary for the patient, we can continue to supply medicines.

Both changes have worked exceptionally well for patients. They have improved the care and service that their pharmacist can provide. They have also increased convenience and reduced the cost to the system.

Another recommendation we have been seeking for years is e-prescribing. The peann luaidhe has no place in modern medicine. We must embrace technology and eliminate the prescribing errors that emerge from a failure to do so. The HSE-approved Healthmail system has been utilised to facilitate the transfer of scripts from doctor to pharmacy.

E-prescribing is something pharmacists have sought for some years. Stock image.
E-prescribing is something pharmacists have sought for some years. Stock image.

Although only an interim measure, this too has worked, despite teething problems, but it is only one step along the way to an appropriate e-prescribing system.

Pharmacists were not surprised that these changes have worked. We have been calling for them for many years. It should not have taken the Covid-19 crisis for the Department of Health to dust off the shelf for good ideas.

As the new Minister for Health Stephen Donnelly gets to grips with the most difficult job in Irish politics and does so at this most difficult time in Irish history, there is one thing he must do and do consistently.

Minister Donnelly must challenge the malaise of certain aspects of our health system and ask why did it take a pandemic for these improvements to be realised.

How many other good ideas are going unexplored in the black hole that is now his Department of Health? Which others could he implement to save time, save money and, most importantly, save lives?

From my own sphere of pharmacy, I can count no less than 20 detailed submissions and constructive proposals made to the Department of Health in the last three years. We have got a considered response to barely a handful.

There are 1,900 community pharmacies in Ireland conducting 78 million consultations each year. If the Department cannot be organised enough to engage with this sector adequately it would not bode well for patients.

The mass production of penicillin was enabled after spores of it were found growing on an old melon. Fortunately, the discovery was not made in Ireland or it may well have wound up in the bin. 

As the crisis gives way to renewal, let us hope that the opportunity to reflect and improve is not lost until the next crisis.

Darragh O’Loughlin is the Secretary General of the Irish Pharmacy Union.


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