Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I have sought this debate because the Health Service Executive, on the direction of the Minister for Health and Children, Deputy Harney, intends to proceed with the unilateral imposition of new scales of payment for community pharmacists from 1 March next. This will pour petrol on the flames of the prolonged dispute between the HSE and the Irish Pharmaceutical Union. Tens of thousands of patients will be adversely affected if the imposition goes ahead and the IPU withdraws from the medical card and drug payment schemes. There was no need for the Minister and the HSE to escalate the dispute in this way. The IPU has welcomed the announcement by the Minister that an independent body will be established to review the contract issues between the HSE and the pharmacists. When the IPU welcomed that announcement, it asked the Minister and the HSE to avoid making unilateral changes to existing payment arrangements pending the outcome of the agreed independent review. The Minister and the HSE carried on regardless.

There is no dispute about the need for better value for money when drugs are purchased within the health service, as prices are far too high. Given that the big multinational pharmaceutical manufacturers and wholesalers have got away with charging exorbitant prices for medicines over many years, why are pharmacists being confronted so aggressively? The Minister is trying to shirk her responsibilities, including her duty to show some accountability, in this crisis. The Joint Committee on Health and Children has asked her to attend a meeting in advance of the 1 March deadline, but she has not agreed to do so. When the committee met over three days last week, it heard thorough submissions from the HSE and the IPU, followed by detailed questions and answers. The seriousness of the situation and the concerns of pharmacists and patients are clear to all Deputies from the many representations we have received. The Minister has not treated the committee, the House and, most importantly, the issue with the seriousness and constructive engagement that is needed.

On the eve of the joint committee's meeting of 14 February last, the chairman of the committee circulated a draft motion which was set to receive all-party support at the meeting. The motion proposed:

That no changes be made to contracts between the HSE and community pharmacists in advance of the setting up, and reporting, of an independent body whose remit will be to make recommendations on the reimbursement to pharmacists for drugs supplied under the State's Community Drugs Schemes, in consultation with the interests concerned;

That the committee recognises the vital role that community-based pharmacies play in the delivery of the health service;

That the committee further recognises that the proposed changes to the contracts between the HSE and the pharmacies should be designed to allow financial sustainability; and

That no changes in the current contract or remuneration will take place until such a body reports and likewise pharmacists will refrain from any reduction in services.

The basis of a solution is in that motion. The Chairman of the joint committee withdrew the motion at the 14 February meeting. In its place, the Fianna Fáil members of the committee proposed a bland motion simply calling on the HSE and the IPU to resolve the dispute. They divided the committee so the motion would be passed. The Government spurned another opportunity to help to resolve the dispute. It seems to have decided to follow a course of confrontation with pharmacists. The Government has doggedly stuck to the position that competition legislation precludes negotiations between the HSE and the IPU on fees. It has spurned every opportunity to amend that legislation to allow such negotiations.

Patients fear that their access to vital medication will be disrupted from 1 March. Medical card patients and everyone who has signed up for the drug payments scheme, especially elderly and infirm people, are particularly concerned. The Minister for Health and Children should immediately require the HSE to defer its 1 March deadline for the imposition of new fees for pharmacists. She should facilitate direct dialogue between the HSE and the IPU on all elements of the new contract, including the cost elements. She must act now to ensure a full and uninterrupted service for all patients. I hope this further appeal does not land on deaf ears. This is a crisis waiting to happen. The Minister must act now.

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