David Cullinane (Waterford, Sinn Fein)

I welcome the agreement. The Minister's predecessor admitted a number of years ago that the engagement with the Irish Pharmacy Union was not what it should have been and the State was not making the best use of community pharmacies. A number of years ago, I published a very comprehensive plan that set out a lot of what is in this agreement, and more, in relation to what we could do. It included many of the important schemes, such as the common conditions scheme, which is very important, provides a lot of potential and can be built on. My plan also included more prescribing, on which there was pushback from the Department at the time. It had some concerns about it but I am glad those issues have been resolved. All of that is important, as is pharmacies playing a larger role in vaccination. Everything we can do to take pressure away from our acute hospitals and GPs, is of value to the health service.

Looking at the volume of community pharmacists we have, it should be accepted that we are simply not making best use of them. They are available, they want to do it, and they can and will do more, but they will say they have to be resourced. As part of discussions I had with them previously, the issue of fees was something they wanted to discuss. I always made the point, in a very honest conversation with them, that whatever discussion needed to be had on fees, there had to be a quid pro quo, a return for the health service and for citizens and better use of community pharmacies. There is still more that can be done. I ask the Minister to see this as a start. This is the beginning and a foundation. It is really good and a step forward, but much more can and should be done over the time ahead. We can build on this and on the agreement that is in place.

I will raise one issue on vaccinations. I strongly believe we should be looking at RSV and shingles vaccination. An application is going through the system at the moment to provide shingles vaccination to those over 65 years of age. There is an issue with the funding and costs of that, but it is very important and should be supported. I always agree that there has to be value for money. I know there is a process but, at the same time, we have to look at what the best way is to protect older people, particularly in an ageing population, where that population needs greater supports during the winter months.

It is actually through prevention, such as the flu vaccine, which is already available, but it should also be through other vaccines where people are at risk and older people at risk. I ask the Minister to look at that issue in the context shingles. It may be complicated by the fact it is not off-patent and there is only one provider. That may be the issue but that should not be a block. The Department and the Minister should look at that.

More can be done by pharmacists on health checks. It was something I put in the plan I published a number of years ago for cardiovascular checks. Unfortunately, it is one of the illnesses that is one of the big killers, along with cancer. We have a lot to do with cardiovascular care. There is a need for a more comprehensive cardiovascular strategy. To park that to one side, there is a lot more community pharmacists can do to help, particularly with health checks and monitoring cholesterol levels for those at risk. They can be tell tale signs there is a problem.

I ask the Minister not to do what her predecessor did, which was take a piecemeal approach to this and make announcements that pharmacists would do wonderful things but not have any of the i's dotted and t's crossed. We saw that with the free HRT and other areas where messes had to be cleaned up as well. Very simply, they had to be cleaned up because the Minister went out and made an announcement without having any engagement with the pharmacists or having any agreement in place. That was the wrong approach. The best approach is to engage with pharmacists and have collaboration and partnership and then have a framework in place that actually works. That is the model I certainly support and the model under which more should be done.

This is welcome. I support it and I called for almost everything that is in this but there is more to be done. We can build on it and hopefully, that is what will be done in the time ahead.

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