Liz McManus (Wicklow, Labour)

I move amendment No. 2:

In page 12, between lines 8 and 9, to insert the following:

"(3) Without prejudice to the generality of subsection (2)(a)(ii), the Society's duty under that provision shall include determining and applying criteria for registration which require compliance with any codes of conduct drawn up for pharmacists and undertakings to comply with such codes.".

These amendments are grouped together and I note that further amendments are coming from the Minister. Is it 4 April today? These further amendments came in at 6 p.m today. I have difficulty with the fact that we have amendments that have just been received by e-mail from the Minister at 6 p.m. today. It causes a certain amount of difficulty in terms of speaking on amendments we have tabled well on time. It may well be that the Minister has dealt with some of the concerns, but I have a few general points to make.

Due to the fact this legislation has been rushed through both Houses, it is extremely difficult to give it the time, attention and scrutiny it deserves. We are all very conscious that the Bill has been surprisingly controversial because there was and continues to be full accord across this House in respect of its central thrust, which is about regulating the pharmacy sector, setting standards and protecting patients where a lacuna existed for a long time. The point has been made that animals were better protected than humans in respect of this kind of service and that we need to put things right. Despite the existence of common accord, a number of key issues are causing great concern from a number of different perspectives.

I appreciate that, consequent to the points made on Second Stage in the Seanad, the Minister came up with amendments Nos. 63 and 64, which relate to potential conflicts of interest. I welcome the fact she has made an effort in this regard. I must again say I have concerns about the very strong likelihood that this legislation will be challenged in the courts and may prove to be defective because of the terrific speed with which it is being delivered.

There are requirements in amendment No. 2 in respect of determining and applying criteria for registration which require compliance with any codes of conduct drawn up for pharmacists and undertakings to comply with such codes. It touches on the concerns that were already expressed by myself and others on Committee Stage about potential conflicts of interest.

We are witnessing a commercialisation of health care which is new to us and for which we are ill-prepared. We should have a very robust licensing system in place for health facilities before we allow the kind of free-for-all that has developed, be it in the hospital sector or in primary care. We have seen predators coming in who have no direct involvement in the provision of health care and who are out to make money out of health care in a way that we have not seen before. It is very important there is strong regulation and robust legislation that can withstand any legal challenge.

There are also medical practitioners who have a certain justification in complaining that the lavish tax breaks afforded to developers do not apply to general practitioners trying to improve their service and accommodation. They have been attempting to develop primary care centres in a certain vacuum because of the failure of the Government to deliver a proper primary care strategy where all the pieces fit. We have a model of 11 centres that have already been provided or are in the process of being provided. I visited the excellent centre in Virginia, County Cavan. That is a model which presents best practice for anybody looking at a primary care centre. Not all primary care centres must be as developed as that. We can have virtual ones as well, but it is a very good example of best practice. However, it appears the Health Service Executive has no intention of including pharmacy within a primary care centre anywhere. Why has the HSE taken a clear policy decision that pharmacy is not part of a primary care centre and that it does not form part of the programme of primary care which the executive itself has initiated?

We are heading into a difficult area where money is being made and collocation is the source of this. That leads to difficulties regarding conflicts of interest. Codes of conduct, safeguards and productions must be robust and clearly defined in law. The doctors made a point about the Medical Council guidelines, but that is a broad and insufficient safeguard for patients in the area of prescribing and dispensing drugs. Unfortunately, we have bad examples on rare occasions from the past and present of inappropriate relationships between doctors and pharmacists that have been to the detriment of patients and patient care.

See this speech in context