The wrong prescription

IT IS hard to feel sympathy for pharmacists when you consider the scare tactics deployed against vulnerable members of the public…

IT IS hard to feel sympathy for pharmacists when you consider the scare tactics deployed against vulnerable members of the public. Unnecessary worry and apprehension was deliberately generated among those elderly patients who require a regular and dependable supply of life-enhancing medication.

Threats of closure and reductions in service went hand-in-hand with the most intensive lobbying of politicians seen for some time. It placed immense pressure on the Government and the Health Service Executive (HSE).

Members of the Irish Pharmaceutical Union (IPU) play rough. Four months ago, in the same dispute, they organised the withdrawal of methadone dispensing arrangements for recovering heroin addicts in Dublin and Wicklow. But they lost the public relations battle and cancelled the protest. Now they are back, threatening the general public. The root cause of this dispute is the determination of Minister for Health Mary Harney to get value for public money. In this case, that means reducing the mark-up price paid to drug wholesalers to an EU average. The situation is complicated by the fact that the main drugs wholesalers also own one-quarter of the State's pharmacies. But small operators are concerned that some of the €100 million savings will eventually come out of their pockets. There is no certainty of that. What is clear, however, is that there is likely to be some income reduction under a proposed new contract.

For the past two decades, various international bodies have urged the Government to introduce competition in areas involving publicans, lawyers and pharmacists. But progress has been painfully slow. In 2002, a ban on new pharmacies opening within a set distance of an established business was abolished, following fierce resistance. In 2005, a Pharmacy Act brought further reforms. Closures and financial ruin was predicted. But the number of pharmacies rose dramatically.

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Nobody welcomes a drop in living standards. And the response by pharmacists to the proposed reforms is understandable. Not only does Ms Harney want to cut the mark-up paid to drug wholesalers, she also wants to pay pharmacists a flat fee for dispensing medicines to public patients. At the moment, pharmacists charge a 50 per cent mark up on all drugs, plus a dispensing fee. Overall, Ms Harney told the Dáil, that amounts to a gross margin of 60-70 per cent. And when expensive medication is involved, the charge can be exorbitant.

At a time of falling Government revenues, the interests of consumers and taxpayers must be protected. That responsibility was shirked in the past. And pharmacists enjoyed a feather-bedded existence. Reform is now under way. Savings of €55 million have already been made by the State on its contracts with drug manufacturers. A scheme to save a further €100 million with drug wholesalers has been proposed. And talks on a revised contract for pharmacists have begun. Its not easy. And it certainly is not popular with those directly affected. But competition and value-for-money requires that this exercise should be completed.