Madam, – One of the most frustrating problems we are all facing is an apparent lack of expertise at the top of the State’s management ladder. Their blunders and mismanagement present a frightening vista that keeps many of us shuddering at the thought of what is coming next.
There is a perception that self-referencing committees sit, deliberate and deliver judgments that are long on both speculation and bias but short on fact. On Thursday, Minister for Health Mary Harney announced another huge mistake that will crucify medical card holders, the public and community pharmacy (“Government to cut pharmacists’ income by €133m”, June 19th).
The experts on drugs and their associated costs are pharmacists. Yet, paradoxically, it appears that because of this expertise we have been excluded from the discussions on the cost-containment process.
It beggars belief that the HSE and Ms Harney’s department are now going to introduce massive cuts in part of the drugs budget with minimal consultation with those that know more about this issue than all their officials.
Pharmacists have long accepted that as a profession we are going to share the cost containment burden alongside the rest of the State.
Indeed, way before the current crisis hit we were lobbying for changes in the drug distribution and remuneration system. In particular, stating there was a much greater role for community pharmacy to improve the process.
It has been obvious for many years that the current system was inefficient, badly structured and wholly unmanaged. Drifting into crisis was an inevitable result of the total lack of any leadership or direction.
Community pharmacists have shown where well more than €100 million can be saved from the drugs budget. Not only can community pharmacists help to achieve these savings, they can also enable the State to deliver a safer and more effective health service.
Currently there is a focus on getting medical practitioners to change their prescribing habits. International and local experience has shown that this is generally doomed to failure. The spectacular failure of the “indicative drugs budget” scheme provides evidence, if it were needed, that hard-pressed medical practitioners have enough on their plate with having to worry about cost optimisation of treatment.
Pharmacists have both the training and expertise to reduce the drugs budget by much more that the current targets. You recently reported (“Proposed drug cost savings fall €50m short”, June 2nd) that the “savings” from the HSE agreement with manufacturers is projected to be much less than anticipated.
It was evident from the most cursory examination of that agreement that it was a triumph for the manufacturers, a prime example of conceding what was already being lost through other mechanisms.
The cuts announced last Thursday will take almost 40 per cent of gross profit from most pharmacies.
A stark contrast with the 8 per cent that the rest of the medical services experienced. The savagery with which this has been proposed belies the completely barren intellectual and management landscape that exists within the decision process.
The irony is that the savings that will be made by eviscerating pharmacy services will be rapidly lost to medical inflation. The losers, as always, will be the public as pharmacy services fail and are destroyed. – Yours, etc,