Catherine Murphy (Kildare North, Independent)

I welcome this Bill. It is clear that there has been much consultation during and prior to drafting of the legislation. The amendment that was introduced in the Seanad was appreciated by the Irish Pharmaceutical Union as it was the major issue that concerned it. The Minister acknowledged in her contribution and in the legislation that pharmacists are part of the health system and I think the local chemist has played a more important role in this regard than is often recognised. I have seen local pharmacists go well beyond the call of duty in cases involving people with long-term and terminal illnesses. It is important to maintain a balance between local retail pharmacies and large chains which provide a degree of anonymity. It is important that the local chemist shop remains a feature of communities and that people feel confident when talking to their pharmacists who can give good advice.

The high cost of medication is a major criticism that pharmacists here often face, although the matter is not entirely in their hands and there is often a limited mark-up involved. Indeed, some medications have no mark-up. I understand that we use other northern European countries as a benchmark in this regard, though this may change. All this has a bearing on how people, particularly those who travel and those with chronic illnesses, will acquire medication. People with asthma, for example, and their family members may go to Spain and Portugal to buy inhalers. Asthma is an example of the type of illness people may self-medicate because of price differences in medication. I do not believe this could happen in the context of an acute illness which necessitates the immediate use of an antibiotic, but it is possible with chronic illnesses. People with chronic illnesses who do not qualify for a medical card and who can buy medication in this way for €20 rather than €100 will make this choice. This is a factor of which we must be aware. Those who do not have a spam filter on their Internet connection will be aware of the large number of companies offering medications on-line at reduced prices. We cannot ignore this practice although I am aware that a considerable amount of these medicines is seized by customs officials when they are shipped in.

It is important to identify trends such as the link between over-prescribing of antibiotics and the incidence of the MRSA superbug. While it may not yet have caused an epidemic, we must gather information on this link to control the problem. To this end, the type of illnesses included on the long-term illness list must be reviewed and the eligibility criteria for medical cards adjusted. As the Minister is aware, self-medication has consequences.

The Irish Medicines Board is highly regarded and its advice is frequently sought in other countries. Although its decision to reduce the number of tablets in packets of over-the-counter medicines has saved lives by preventing people from intentionally or unintentionally misusing such medications, the higher cost of smaller packets results in people buying in bulk while abroad. We need to monitor and gather information on this trend. For example, an examination of the products seized by customs officials would determine what types of medicines members of the public are purchasing on-line or while abroad.

Will doctors' surgeries and chemists which share a premises be required to change this arrangement within a specified timeframe? I am familiar with several chemist shops which share premises with a GP surgery. This could be construed as having prescribing and dispensing alongside each other but in many cases it is a long-standing arrangement. In addition, it may well be the most appropriate arrangement in some areas with a small population.

Under the legislation it will be easier to establish a pharmacy here than in any other European Union member state. I understand some of our European partners are examining the possibility of re-imposing regulation in the pharmacy sector. We need to monitor the arrangements, particularly as Irish pharmacists will continue to be prevented from establishing a pharmacy in certain other countries.

I welcome the initiative to appoint to the council of the Pharmaceutical Society of Ireland five persons who have never been pharmacists in the State or another jurisdiction and are representative of the public interest. These persons must be selected using an appropriate procedure. For example, individuals involved in patient rights or advocacy groups should be appointed to the council. While I do not accuse the Minister of political patronage in her appointments to State boards, the power of appointment can be abused. For this reason, clarity is required on the type of persons who would be appropriate for appointment to the council. The appointment of laypersons can bring balance to a board and is welcome provided it is done properly.

See this speech in context