An investigation into complaints that a GP favoured her son's pharmacy practice in another health board area over a local pharmacy still has not been published, three years after its completion. The Health Service Executive has refused to say why the report has not been published or if any of the recommendations were acted on, despite repeated queries from The Irish Times.
The health board-commissioned report was completed in September 2003. It is understood that it found that the GP and her pharmacist son had breached elements of their contracts. The report authors are understood to have recommended that the chief executive of the son's health board be informed of the findings.
It is understood that the report also found that patient care was being compromised in an arrangement that involved the GP's son delivering medicines to patients' homes.
The report's two authors drew attention to a lack of adequate control systems, accountability requirements and risk management factors in the labelling of drugs in a health board community nursing unit. The drugs were supplied by the GP's son to fill her prescriptions.
The Irish Times believes the report also recommended that the GP's health board seek a review of all prescriptions issued by her and dispensed through her son to establish if any irregularities existed.
The inquiry was established after the local pharmacist complained to his health board. At that time, the GP dispensed prescriptions so she would regularly order her medical requirements from this pharmacist. He also filled her prescriptions for the nursing unit until the matter came to a head in 1998.
After qualifying, the GP's son acquired a pharmacy practice 44 miles away in another county and another health board area. The GP told the local pharmacist that she wanted to divert half of her stock orders to her son's pharmacy. The local pharmacist questioned the legality of this as the health board contract stated that the GP should get the drugs from a pharmacist who had his premises in the medical practitioner's normal area of practice.
However, the health board agreed to allow the GP to do this for six months in the anticipation that it would save money. The pharmacist complained to the health board and the health board rescinded the agreement.
In late 1999, the GP transferred the medicine needs of her medical card patients in the nursing unit to her son. Despite the GP's claims to the contrary, it is understood the report found no evidence that she had consulted the home's management before doing this.
The inquiry team visited the unit and found that none of the medicines for medical card patients was labelled with the patient's name, as would normally be the case. It is understood that the report found that this constituted a risk to patient care, and that it lacked adequate control systems and accountability requirements. It is believed that the report recommended that the health board, rather than the GP, should decide the appropriate pharmacy arrangements for the unit.
In 1999, the GP decided to stop dispensing prescriptions at her practice. The local pharmacist then discovered that her son had begun supplying medicines to some patients from the boot of his car in the health centre car parks when his mother was holding clinics.
He was ordered to stop this when his health board became aware of it. It is understood that he then began delivering medicines to patients' homes. The authors raised concerns that patient care was compromised by the fact that more than a month's supply of medicines was being delivered to some patients.Neither pharmacist wished to comment on the report, but the GP said she was satisfied that the inquiry team had found that everything was "completely above board".
