Madam, - As a practising pharmacist for nearly 30 years and someone who had the honour to serve as Minister of State with responsibility for Mental Health, I might be able to point out some indisputable facts that all parties in the dispute between the HSE and the pharmacists would do well to remember. Some consideration of the realities might slow down the headlong march over the precipice.
The most important party in this dispute is that group of patients who need their medicine as soon as possible after they come to the pharmacy from the doctor or the hospital. Where those patients suffer from any form of mental illness or condition, it is emphatically unacceptable that they might be be unable to have their prescription filled. Even the threat of such an eventuality will alarm the vulnerable people concerned and may compound their condition. Everything I say must be read in that light.
Minister Harney, with whom I had the honour to serve in the last Government, deregulated pharmacy and we have, as a consequence, approximately 300 new pharmacies. These are mostly owned and operated by young pharmacists who have entered (freely) into a series of agreements with the HSE, financial institutions and pharmaceutical wholesalers.
They have signed binding legal contracts and their primary concern, as far as I can tell, is to abide by those contracts while delivering the best possible service to the public.
The HSE - without any consultation - has decided to move the goalposts in this arrangement in an attempt to, effectively, "claw back" €100 million a year from the pharmacists. That attempted "claw-back" will be introduced without any study of its effect on pharmacists' incomes or of its effect on the present satisfactory geographical spread of pharmacies. Will it threaten some rural pharmacies that would be disproportionately dependent on older holders of medical cards?
If so, what is to become of the service they they did offer? Who will open up the pharmacies in rural areas with older populations? Has this even been considered?
If the changes go ahead as scheduled, the implications for our national delivery of pharmaceutical services will, in my view, be catastrophic. And I say that as someone who is perfectly cognisant of the need for value for money in the overall delivery of health services and someone who supported - and indeed, still supports - the principle of the HSE.
I believe that the regulatory body, the Pharmaceutical Society of Ireland, stands ready to participate in a study aimed at introducing beneficial reforms based on a comparison with the systems operated by other countries. The ministerial appointment of Sean Dorgan to chair the independent body that will report - in a few months - on all aspects of the pharmaceutical service is also to be warmly welcomed.
I appeal to all concerned to pause before irreparable damage is inflicted to a system on which some of our most vulnerable, not to say helpless, people rely. I do not doubt that negotiations, conducted in good faith, would yield an answer to all the concerns. But acting in a unilateral and pre-emptive fashion can never show us the way forward.
Accordingly, I call on the HSE, in the first instance, to announce the suspension of its attempted "claw-back" and give the situation the space that is so badly needed if we are to see this dispute resolved.- Yours, etc,
TIM O'MALLEY, FPSI, Milltown, Ballysimon, Co Limerick.