James Reilly (Dublin North, Fine Gael)

The reality is that what has been attempted does not address the real issue the Minister has raised, which is the margin that wholesalers have, because as she already pointed out the HSE cannot negotiate with wholesalers nor the wholesalers with the HSE, because of the wonderful competition law. The HSE misled the Joint Committee on Health and Children by telling it that it had a letter from the wholesalers assuring it that pharmacists would not be charged more than the reimbursed cost of drugs by the HSE. No such letter existed. What existed was a letter to an individual pharmacist from one of the wholesalers saying that it would "endeavour to ensure", which is a far cry from a guarantee, that drugs would be provided at the reimbursable cost. No guarantee was given and this letter was certainly not addressed to the HSE.

Furthermore, the Joint Committee on Health and Children received a letter from the same wholesalers making it clear they would not be able to supply drugs to some of their community pharmacists, especially the smaller rural ones, under the new arrangements at the costs suggested by the HSE, completely contradicting what the HSE had been saying. An issue raised by the HSE during the course of the joint committee debate and by the Minister today was that there would be no change to contract structures — what beautiful use of the English language — but that of course does not mean there would be no change to contractual quantums. It is double speak, if ever there was double speak.

I want to lay on the record of this House yet again that my primary concern is for the continuity of care for patients and continuity of medical supply to the most vulnerable citizens in our community, who are the elderly, the chronically ill and the disabled. Serious illness is a grievous enough burden to carry without having to worry whether one will be able to access medication.

The net effect of this current action at the least will be the closure of many rural pharmacies as they find themselves sandwiched between the HSE and the wholesalers. Those most vulnerable are the younger pharmacists who have purchased pharmacies in recent years and have serious overheads and loans to repay. They will go out of business, thus further denuding rural Ireland of essential services. We have already lost the banks, the post offices and now the pharmacies may go. Rural GPs will be next, no doubt. The Minister will complete her agenda, namely, to have corporatised pharmacies in the large urban areas without any regard to the needs of the hundreds of thousands of people who populate our rural areas.

It is interesting that the concerns I have just raised with the Minister are raised in a letter from her ex-colleague and former Minister of State with responsibility for mental health, Mr. Tim O'Malley.

See this speech in context