THE FOLLOWING is the full text of a letter sent yesterday by the HSE to Dr Ambrose McLoughlin, the registrar of the Pharmaceutical Society of Ireland
Re: Community Pharmacy Contractors
Dear Dr McLoughlin,
As you are aware, the Minister for Health and Children, with the consent of the Minister for Finance, signed the Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2009 on the 1st July, 2009. The regulations give legal effect to the decision of the Minister under section 9 of the Financial Emergency Measures in the Public Interest Act 2009.
The Act also includes a provision (section 9(8)) which allows a contractor to withdraw from the provision of services under the State Drugs Schemes and terminate their Community Pharmacy Contractor Agreement by giving 30 days’ notice.
A significant number of pharmacy contractors had exercised this prerogative but then subsequently withdrew their notice of termination. However, as of Saturday, 1st August, 2009, approximately 490 community pharmacy contractors had valid notices of termination in place.
For the majority of those contractors, Saturday, 1st August, 2009, was the effective contract termination date.
To ensure continuity of supply of medicines to patients the HSE put in place a number of contingency measures including the establishment of nine alternative dispensing units on HSE sites in the areas worse affected by the withdrawal of services.
In operating its contingency arrangements, a number of issues arose for the HSE which, in your statutory role as regulator of the profession, I believe you would wish to be made aware of.
They are as follows:
Pharmacy staff in some of our dispensing sites were subjected to intimidation by community pharmacy contractors. A report on these incidences will be forwarded to you under separate cover in early course;
A number of pharmacy contractors who, while not having issued a valid notice of termination or who having subsequently withdrawn one, made their services unavailable without adequate prior notice. This action was taken notwithstanding the fact that the supply chain capacity had already been reduced as a consequence of the numbers withdrawing on foot of valid notices. This fact would have been known to the contractors who made their services unavailable. I am in the process of compiling specific details on these instances and will forward to you as soon as they are ready;
A number of pharmacists who have not terminated their contract refused to dispense to patients whom they perceived as not their own customers. As you are aware, the State Drugs Schemes are so designed as to provide the patient with a choice of pharmacist for each dispensing episode. There is no basis under the community pharmacy contractor agreement for a contractor to refuse to dispense to a patient who presents with a valid prescription simply because they are not considered as their own customer.
A report will issue on specific instances in the coming days.
Apart from the obvious contractual issues that arise for the HSE from the foregoing, there are, more importantly, serious patient care and professional/ethical considerations at issue which I would like to bring to your attention in the context of your regulatory role under the Pharmacy Act 2007.
As stated above, I will forward the specific details to you in early course.
Yours sincerely,
Pat O’Dowd,
Asst National Director
(Contracts)