James Reilly (Dublin North, Fine Gael)

I thank my colleagues in the Labour Party for bringing this issue to the floor of the House. Although it is not the first time for a Bill of this nature to come before the House, this one has come about primarily because of the situation pertaining to the threatened cessation of pharmaceutical services throughout the country. Clearly the issue has been that the HSE has used the Competition Authority as a means not to negotiate with them or to allow them to be represented by their union. Their union was formed many years ago and it serves a useful function because it allows negotiations to take place between the State and pharmacists. When those negotiations are concluded the State can depend on the union to ensure that pharmacists will abide by the arrangements.

I am not sure what the Government or the Competition Authority are proposing in the current scenario. Are they proposing that individual pharmacists should do individual deals with the HSE? They must surely realise this would result in areas having no service because pharmacists would not be prepared to engage with the HSE under the terms on offer, while it may be successful in other areas. Will it lead ultimately to the closure of many rural pharmacies, further undermining rural communities that have suffered enough following the removal of many other services? If this continues, how will the Government engage in further roll-outs of services with other professionals?

Many dentists have pulled out of the dental scheme. They have not done so in a co-ordinated, concerted fashion but they have drifted away from the scheme. Their union cannot negotiate a change in terms and conditions and the dentists are walking away from what they see as a loss leader. The same will happen with pharmacists. How will future arrangements be put in place with general practitioners to roll out cervical screening or with chiropodists if the diabetes programme is rolled out nationally or with physiotherapists and so on? These are all areas of activity where because of a quirk in the law the professionals involved are independent contractors as opposed to employees. Most people cannot come to terms with the fact that consultants can be recognised and are represented by a trade union because they are employees but general practitioners, dentists, chiropodists, physiotherapists, pharmacists and actors cannot. This is inequitable and something needs to be done about it.

Unfortunately, I must apologise because our legal opinion does not permit my support of the Bill. I sought legal opinion independent of Fine Gael which concurred with advice received by my party. However, that does not take away from the intention of the Bill and the serious issue involved. Members of Fine Gael and the Labour Party called on the IPU and the HSE to back away from their entrenched positions, which thankfully they did, to allow time for negotiations to take place and a process to evolve to get around the Competition Authority issue, thereby allowing for many facets of the dispute to be resolved without talking about pricing, which was ultimately to be discussed in a parallel forum that would not be in conflict with the authority. I am deeply concerned that the negotiations are not moving apace and the time that was bought has been frittered away.

IPU representatives have been in court since this issue was last discussed in the House and the union's offices were raided by the authority. Such behaviour during an industrial relations dispute does nothing to build trust and it only serves to intimidate and anger people. This is no way to run a civilised democracy. The perception of intimidation is unacceptable and this is not the first time it has occurred. No more action of this nature should be taken and the authority should stand back until the negotiations are completed and a resolution found. If issues still remain for the authority at that stage it can act then, but it is counterproductive to act in this way at this time. Irish people reject being subjected to such treatment and all it does is cause revolt. This treatment pushed the pharmacists over the line and they withdrew their services for the methadone scheme. They were on the verge of returning until certain people were raided by the Competition Authority and they blew a fuse.

I will not approve of action that leads to the diminution of service or places patients in danger by the IPU or the HSE, which is very culpable. The executive is using the Competition Authority to refuse to engage with the IPU and it is not displaying goodwill to find a way around this. Where there is a will, there is a way but if there is no will, there will not be a way and this is clearly what is happening. I hope that this problem can be resolved through a negotiated parallel structure, which has been mooted. The IPU e-mailed all Members earlier stating:

The Union has proposed that talks on a new pharmacy contract, under an Independent Chairperson, should commence immediately. The purpose of these talks would be to reach agreement on all aspects of the contract, including an appropriate pricing structure for the delivery of pharmacy services. This had previously been agreed with the HSE at a meeting in November. When agreement is reached on an appropriate pricing structure, the matter could then be referred to the new proposed arbitration system, which the Minister for Health and Children alluded to in the Dail on 21st November 2007. It is hoped that such a Body or System will provide an independent and fair assessment of all the issues involved and could then make recommendations to the HSE on pharmacists' remuneration.

We are faced with a serious problem and the elderly and the chronically ill will be worried about continuity of their medication after Christmas. That is unacceptable and I appeal to the HSE to engage properly in this process to find a way around this problem. I am sure the executive can if it displays goodwill. Mr. Shipsey is still involved and there is no reason the process should not succeed.

Some years ago it was prescribed that Ireland should rationalise its union structure from a large number of small unions to a small number of large unions to mirror the practice in Germany, which at the time had a good industrial relations record, was a leading economy in the EU and had engaged in a social partnership type arrangement. We have come full circle and the Government is recommending that it cannot deal with certain unions such as the Equity actor's union and the Irish Pharmaceutical Union and wants to deal with suppliers of services individually rather than collectively. This is a recipe for disaster and anarchy, which will lead to fragmented industrial and commercial relations between the Government and these sectors. Of what is the Government afraid, given it is in the most powerful position as the central purchaser of services?

It is reasonable to re-examine the potentially chaotic scenario that may evolve if an alternative, workable legal replacement is not provided so that legitimate groups may communicate with State bodies in an efficient non-combative manner. Arbitration could be used in conjunction with the review of the Competition Act under way and the messenger model adopted in the US could also be used, as Deputy Varadkar stated. The Competition Authority is not the arbiter of law. It is a prosecutor and it must go to the courts to prosecute, where it does not always win. Going forward, how do the Minister and the Government propose to deal with members of the extended medical profession such as dentists, physiotherapists, general practitioners and chiropodists when it wants to roll out community services? Will it approach every professional individually?

There is a country in the eastern part of the world in severe distress and if the powers that be could negotiate with one warlord only they might have an opportunity to achieve peace, but it is proving impossible because there are 25 warlords. The same applies when a single body fronts up for a group of bodies. It is much easier to do a deal and make it stick rather than make separate deals through the country, which would be unworkable. That would lead to a diminution of service in rural areas. I ask the Ministers concerned and the Government to address in a proactive manner a solution to the predicament resulting from the enforcement of the Competition Act and EU treaty regulations and arrive at a realistic method of communicating with key service providers without the need for confrontation but rather in mutual co-operation.

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