Pharmacy row: Consumer choice curtailed by one-stop-shop outlets, says chemists' representative body. Brandon Glenn reports.
The recent trend of combining pharmacies with doctors' surgeries under the same roof could reduce the choices available to consumers and make it more difficult for elderly, ill and low-income people to obtain the medication they need, according to the Irish Pharmaceutical Union (IPU).
But proponents of the practice say it is more convenient for consumers, allowing them to submit their prescriptions to the pharmacist immediately.
Combining doctors' surgeries and pharmacies in health centres reduces overhead costs for pharmacists and general practitioners (GPs), enabling them to pass the saving on to their customers, they say.
It is difficult to ascertain how many or even if any same-site doctors' surgeries and pharmacies exist in the Republic, but the IPU's Olive Stephens said there was plenty of anecdotal evidence that such health centres were being planned.
She said her organisation received three or four calls about the health centres each week from its members.
A spokesman for the Department of Health said he was not aware of any same-site pharmacies and doctors' surgeries currently operating in the Republic
When told of the spokesman's comment, Dr Bill Fegan, a member of the Irish Medical Organisation (IMO) with a practice in Finglas, Dublin, said: "He better be made aware of it."
Dr Fegan said he knew of "very few" health centres in which a GP was on the same site as a pharmacist, but declined to name any.
"Everybody is being careful," he said, noting that some GPs located themselves in the same building, but on the floor above a pharmacist.
"The reason they're upstairs is that it suits both the doctor and the pharmacist to do that. It's time to drop this charade," he said.
Ms Stephens said her organisation feared that many independent pharmacists in small, rural towns would be forced out by pharmacies that were on-site at health centres. She said that many of the IPU's 1,400 members had said "it would have a detrimental effect on their businesses and could potentially lead to closure of pharmacies".
This would reduce consumer choice and make access to a pharmacist problematic for people who do not live close to health centres, particularly individuals who have difficulty travelling, like the elderly, sick or mothers with a lot of children, said Ms Stephens.
Dr Fegan said he thought it was unlikely that pharmacies would join rural health centres, and that the IPU's "fears are rather unfounded in the less densely populated areas" because the costs of opening health centres in such areas were too high.
He did concede that "in densely populated areas some pharmacists will lose out".
The IPU says it is important that there be "a clear distinction between the role of the prescriber of medicines on the one hand, and the dispenser on the other - from both consumer confidence and safety perspectives".
A report by the Pharmacy Review Group, which was published without comment on the Department of Health's website, recommended that "there should be no beneficial ownership or business interest of any kind between dispensing and prescribing" medicine.
It also states: "Pharmacies and general practices should occupy discrete premises, with separate entrances."
Ms Stephens said the IPU had pressed the Minister for Health, Mr Martin, to act on the recommendations, and that he had stated that pharmacies in health centres would act as "a barrier to trade". "We've been trying to push him saying, 'You've made it clear to us on two separate occasions that you have concerns about pharmacies and health centres, and now it's time for you to do something about it,'" she said.
Mr Martin's spokesman said the Pharmacy Review Group's recommendations were under consideration and that generally recommendations were taken into account.
However, Dr Fegan disagrees with the group's position. "I think it's a recommendation that has passed its sell-by date. It's an old-fashioned way of thinking."