Members of the Irish Pharmaceutical Union (IPU) should be ashamed of the tactics being used on their behalf in a dispute with the Health Service Executive (HSE). The withdrawal of methadone dispensing arrangements for an estimated 3,000 recovering heroin addicts in the Dublin and Wicklow areas represents an assault on one of the most vulnerable and marginalised groups in society.
What makes it worse is that these citizens, who are attempting to put their lives back together, are not directly affected by the contested reforms.
It is not the first time this defenceless group has been targeted by members of the IPU. Six years ago, as the Government prepared to address anti-competitive issues that provided the highest drugs mark-up in the European Union, the IPU threatened to refuse to deal with new methadone patients. Since then, reform has moved with glacial slowness. Matters have now come to a head because the HSE plans to reduce the wholesale mark-up price it will pay for drugs to an EU average of 8 per cent. Methadone is not affected. But the IPU claims its members would end up dispensing drugs at a loss under the medical card scheme if the reforms go through.
The recent ending of a cartel arrangement within the industry and new requirements of competition law have certainly sharpened attitudes. The IPU is demanding the HSE should negotiate directly with it on fees for dispensing drugs. But the HSE has been advised this would now breach competition law. At the same time, the Competition Authority and the Pharmaceutical Society of Ireland have made it clear that the withdrawal of methadone services by an estimated 10 per cent of pharmacists may be both illegal and unethical.
It is understandable that pharmacists should seek to maintain their standards of living. But this is not the way to go about it. Profit margins within the industry are the highest in Europe and the OECD has consistently urged regulatory reform in order to bring prices down. Using methadone patients as a battering ram in their dispute is unconscionable. The HSE has recognised the proposed remuneration structure is unbalanced and is willing to address the issue. But not through direct talks and the re-establishment of a cartel structure.
Methadone patients who revert to heroin use arising from this dispute are in danger of overdosing. Others may be unable to cope with their altered circumstances. Such humane considerations should be enough to end this protest by pharmacists. Otherwise, the majority of their colleagues should speak out. Lives are at risk. Disgraceful, bully-boy tactics must end.