Bill targets deals between GPs and pharmacists

The Government is to seek to ban controversial economic relationships between doctors and pharmacists in new shared health centres being developed around the State as part of a clampdown on conflicts of interest which could affect patients.

The moves will rule out the charging of excessive rents for inclusion in new health facilities or the provision of leases at below commercial rents. It also outlaws patients being directed towards a particular pharmacy on site to have their prescriptions dispensed.

However, the Irish Pharmaceutical Union (IPU), which represents 1,600 community pharmacists, said last night the amendments did not go far enough. It wants a total ban on locating pharmacies ihealth centres. It said the only way to protect patients was to prohibit all business relationships between the two professions.

Under amendments tabled to the Pharmacy Bill by Minister for Health Mary Harney, GPs and pharmacists will be prohibited from having a beneficial interest in the other's practice, including company or corporate relationships, or a relationship by way of preferential leasing or tenancy arrangements.

Ms Harney told the Seanad last week that in future a pharmacist could be charged only the normal market rent for facilities in a centre shared with GPs. She said it would be considered professional misconduct to enter into an agreement where rates above normal market rent were being charged for a premises.

The Minister said regulatory bodies such as the Medical Council and the Irish Pharmaceutical Society would be given powers to investigate conflicts of interests in this area through fitness to practise hearings. "In the first instance, all of this is being done to ensure appropriate behaviour on the part of professionals and that economic interests will not influence what is asked of patients or the manner in which they are dealt with. This would not and cannot be acceptable."

She said the legislation would bring to an end the stories of pharmacists being charged large amounts of money for inclusion in new health centres.

Senator Mary Henry told the Seanad that in some instances pharmacists had been asked for "key money" of up to €1 million to be allowed set up as part of a new health centre in an area.

Ms Harney said the Government was not planning to ban co-location between GPs and pharmacists. "What we are seeking to ensure is that a doctor cannot have an interest in the pharmacy business and vice versa. We are also ensuring any rent paid must be at the normal rate. We are giving both regulatory bodies very strong powers in these matters," she said.

"It will be professional misconduct to enter into an agreement where above normal market rent is being charged for a premises. For example, if it were the case that a doctor's rent was subsidised and a pharmacist's rent was hiked, I would have a significant number of concerns."

She said under the new legislation doctors could not recommend a particular pharmacy. She said doctors could inform patients about pharmacies' opening hours in a particular location and a pharmacist could inform a patient of a doctor's opening hours or location. "However, they are not entitled to recommend each other and where there is co-location, there will be an obligation to have separate entrances to the individual facilities," she said.

IPU vice-president Liz Hoctor said if pharmacies were allowed to operate in health centres it would enable one pharmacy to corner the market, undermining the viability of other pharmacies.