Plans by the Health Service Executive (HSE) to introduce reduced payments to pharmacists for drugs dispensed to medical card holders will go ahead on March 1st, Taoiseach Bertie Ahern has signalled.
Mr Ahern told the Dáil that "the HSE now intends to implement revised arrangements on March 1st and it also intends to enter discussions with the IPU [Irish Pharmaceutical Union] on the development of a new substantive pharmacy contract as soon as possible".
He said Minister for Health Mary Harney "wants to agree a contract, which must be done", and the Department of Health had indicated that interest "has been expressed by pharmacy chains and individual pharmacies in the new interim contract offered by the HSE".
TDs and Senators from all parties have criticised the manner in which the HSE plans to reduce payments to pharmacists by €100 million, but Mr Ahern urged the two sides "to lower the temperature, agree the contract and then allow the Minister to look at the fees element".
He rejected a call by Fine Gael leader Enda Kenny for the immediate appointment of an independent arbitrator. He said Ms Harney was working to develop appropriate arrangements "for the development of contracts and the setting of the fees payable", and "this may include the establishment of an independent body" which would look at all the issues including appropriate fees.
When Mr Ahern appealed to the two sides to agree the interim arrangements so that the fees could be looked at, the Fine Gael leader said that was "putting the cart before the horse".
Denying this, the Taoiseach said "you can't negotiate a fee with somebody if you don't have an arrangement. Let us not be unreasonable about this. It does not seem an unreasonable position for the sides to take and they should consider it". The issue was raised during leaders' questions and Mr Kenny said there was "much anxiety among people who use the GMS system, who number well over one million . . . and are among the most vulnerable in our society, that they will not be able to obtain their medicines after March 1st".
Mr Ahern stressed that "if any community pharmacists decide not to honour their contracts they must give three months' notice. No pharmacy in the Republic, to the best of my knowledge, has provided such notice. Thus, the issue should not arise."
The health committee discussed the issue on Tuesday and yesterday and Mr Kenny pointed out that "although the Taoiseach says the draft interim contract is to be implemented on March 1st, the committee was told yesterday that this was a voluntary interim contract but that the changes at stake would still be implemented by the HSE", which he said would be "precipitative".
Mr Ahern agreed there should be no "precipitative" action, but pointing out that that the HSE had contracts with 1,600 pharmacists and "if anybody wishes to break from this contract, they must give three months' notice. That is the legal fixed position.
"In respect of interim arrangements, if nobody has declined the contract, that is the position."
He added: "The crux of the matter is the wholesale margin in this country is more than double that found in any other country in Europe, including Northern Ireland. We must work to find a solution, which we have been doing. It is an enormous margin."