With chains taking over from many independent pharmacies, and the role of pharmacists evolving, we talk to some of the owners of longer established pharmacies in Ireland about their changing role in the community today.
"There's not many of us, I think, in Ireland that can say there's a third generation involved in running the pharmacy," says Rosemary Conway.
Her daughter, Caoimhe, has gone back to college to study pharmacy at Trinity College Dublin, with a view to taking over the business in Ashbourne, where she's been working with her mother for six years. It's the pharmacy that Rosemary's dad, Sean O'Conmhi, set up 60 years ago. Back then, Ashbourne had a population of about 250 people.
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“When Dad came to Ashbourne, he was obviously very young at the time, so he brought a great lease of life to the community. He was popular and he became very involved in all the local activities.
“People relied on him an awful lot because he was a county councillor as well. I remember a night never went by without somebody coming to the door, looking for his help with something or other. You’d be coming in and Dad knew everybody by name,” says Conway.
Familiarity
That familiarity is something that Elenora Hogan, who runs Hogan’s Pharmacy in Limerick with her sister Marie McConn, knows all about. Their dad opened the shop 75 years ago and since then generations of customers have remained loyal.
“You build relationships over the years with the customers and, in our particular case, we’d have quite a number of fourth generation families dealing with us who would have traditionally always come to Hogan’s, through my father’s time and my sister’s time and our joint time. Friendship as much as anything else keeps them coming in, and the fact they know they can ask us anything and we’ll give the best advice we can.
“When they say they’re coming in to Hogan’s, they know they’re coming in to one of the Hogans,” says Elenora.
Veronica Cosgrove took over her business, Cosgrove's Pharmacy in Monkstown, only in 1994, but it was first established in 1882 by George Lane McCormack. While she didn't have a family connection to the shop, she has found her customers place huge value on the old community pharmacy feel the place still retains.
When she took over, she restored all the old finishings and brass fittings, and a preservation order has meant that it retains all the original pharmacy bottles, the old lavender salts jars and the pharmacy scales.
“There was a preservation order on the bottles when we took over and I think the people in Monkstown were so happy when we kept it and, in a sense, it’ll never go out of fashion. Our pharmacy will always have to be restored to keep it looking good, but if we changed it I think people would be very upset to lose that old feel. It’s not so clinical when you go in,” says Cosgrove.
While people still value local, independent pharmacies, the job performed by the pharmacist has changed considerably.
William Boles is now 85 and was born above his father's pharmacy, AC Boles, in Inchicore, which was founded in 1928. His mother was also a pharmacist, something he says was very unusual at the time.
He began working there as a pharmacist when he was 21, but “I would have helped in the shop from the age of six or eight,” he says. He retired only this year. When he began his career, weighing drugs and mixing up medicines were a huge part of the job.
“The doctor would order this powder and that powder and this thing to be mixed up together. It’s something we made up specially for the person, but of course the doctors ordered the same thing regularly for different people, so we didn’t make it up every time; we might make up a large bottle that would contain a lot of it. Now 99 per cent of prescriptions are pre-prepared tablets or capsules or liquids and we just supply them,” he says.
“To go into the back and compound and make up stuff, there isn’t time to do that anymore. They’d be very strict about everything now . . . If you look at the mixtures now, Benilyn and things like that, they’re based on old remedies. If you look at the old remedies though, some of them contained things like opium that wouldn’t be allowed now.
"Old Collis Browne Mixture was recommended for everything and no wonder if you look at what was in it – it would cure you of anything. That wouldn't be allowed anymore," says Cosgrove.
Compounding
While compounding is no longer the norm, pharmacists have become increasingly involved in providing other services, to take some pressure off
GPs, according to Hogan. “The role of the pharmacist has devolved and pharmacists are now involved in the flu vaccination programme and emergency hormonal contraception programme as well as operating the many schemes that are provided by the State,” she says.
“With the different services that are provided, it’s opening up the whole pharmacy sector, which is good,” says Rosemary Conway, though she notes there is still huge skill in community pharmacies, and dispensing drugs isn’t all that there is to the job.
“Dad’s whole thing was that you need to listen and take on board what’s being said because often there are underlying things there. I just see with our pharmacists that they sort of know when people need to talk a little bit more about whatever it is that’s going on.
“All those years ago, the role of the pharmacist was hugely important because you’re dealing with people who aren’t well and that has still stayed. I often think that the knowledge of medicine, the knowledge of diseases, that’s all as relevant now as it was 60 years ago,” she says.
Biggest challenge
The biggest challenge for local independent pharmacies today is keeping the doors open, says Boles. “Crudely and bluntly, economic success is the challenge for everyone. The doctors can be fickle, they could be ordering a lot of one tablet and if we buy a lot of it, we get it at a reduced price, but the doctors then might start using a different one, but that’s just part of life. You just have to take it in your stride.”
Cosgrove agrees, citing some of the big problems as Health Service Executive (HSE) cuts and reference pricing, a system which sets a price the HSE will pay under the Drugs Payment Scheme for groups of medicines that do the same job, regardless of whether the doctor orders or the pharmacist dispenses a patented drug rather than the cheaper generic alternative.
“You might have had all that stock [of patented drugs] and you’re just going to be paid less. You could be talking about €15 in the difference. You have more and more tablets every year going to reference pricing,” she says.
“I understand that savings have to be made in the health service, but pharmacies unfortunately are being challenged on a regular basis.
“ It’s expected you provide all these extra services and many you’re providing free of charge, so they’re putting a huge amount of pressure on you, but not giving you the resources to do it. We’re just very lucky we have three pharmacists employed.”
With additional pressure coming from pharmacy chains that run with lower operating costs, Hogan says running an independent pharmacy is becoming harder.
“It’s a challenge, but it’s something we hope to do for a while more. As long as I can, I would like to be able to run it as a family pharmacy,” she says.
Community
It’s important, says Cosgrove, that independent pharmacies remain, because of the role they play in the community, something that applies beyond just pharmacies.
“I have one member of staff who’s been there since I opened, and for customers coming in, it’s great to see a familiar face. It’s about somewhere to call to.
“Especially when you’re in the community and you don’t want to drive and your children have gone away, you need some contact, even to come down and ask do we know this or that. The flower shop is very important next door as well. All these places are very important to keep the community together and so people know they have some place to call to. You’re not just a number,” she says.
