Gillian Toole (Meath East, Independent)

I wish to convey my most sincere thanks to the Minister, Deputy Carroll MacNeill, to the officials at the Department of Health, in the Health Service Executive, and in particular my former colleagues, as I am no longer practising, in the Irish Pharmacy Union, in particular Kathy Maher, the contractors committee and the executive, who have done sterling work over the years, which is now being recognised. This is a case of tús maith leath na hoibre. I take on board suggestions that colleagues made. I assure them that they are embedded in this agreement, and in conjunction with the soon-to-be formed strategic collaboration group, all the suggestions that have not been addressed will be through that structured format, which did not exist prior to this.

It is an excellent start, 16 years since the financial emergency measures in the public interest, FEMPI, adjustments after the 2009 contract. There is massive potential here. This is a case of community pharmacy moving forward in conjunction with the medical profession. That is across the board. It is not one or the other; this is a collaborative effort. This will ease pressure on general practitioners and accident and emergency departments. It is all about getting the right medicine to the right person at the right time. Community pharmacists are medicine experts. There is a medicine optimisation process with a commensurate fund. Members have expressed a fear of phasing, and that phasing may be scaled out. That is not at all the case. Under the medicine optimisation process, for patients at high risk or medicines that have the potential for misuse, phasing will be continuing but it will be limited to a defined set of medications.

If issues develop where patients are considered to be unsafe or where their care has to be reviewed, that will be possible to review under the strategic collaboration group. There are a huge number of opportunities, such as medicine usage reviews, and the issue of waste was addressed. On medicine usage reviews, I carried out a pilot with Dr. Martin Henman from Trinity College Dublin, TCD, 30 years ago. It was a paper-based effort but it was fantastic. We would sit down every three to six months with patients and review their medicines, including even things they had at home.

It was called a brown bag and it was on an ad hocbasis. Again, there is potential to bring this forward and have that as an actual process. The disposal of unwanted medicines properly has a beneficial cost impact, but also a positive environmental impact relating to water quality and human health in general. It is something I called for at county council level in the past. I am delighted to see it coming forward. On chronic disease management, a Sláintecare initiative, many of my colleagues in County Meath were involved in a Healthy Meath chronic disease management programme, which produced fantastic results. There were calls for cardiovascular screening and other initiatives. The sky is the limit, starting from this agreement, assessing patients' needs and factoring that into future projects. On the management of common diseases, this will be a game changer in reducing delays in access to general practice and accident and emergency departments. That is to be welcomed.

There is one query that I have which is relevant to medicines availability and also future services, reviewing and analysis the early stages of this agreement. It is the issue of the chief pharmaceutical officer. What is the timeline for the appointment of a CPO to the Department of Health? Are there any plans to appoint a chief pharmaceutical officer to the Health Service Executive? These personnel will be key to the collaboration and co-operation piece under the strategic plan. I am no longer practising but having practised for 35 years it is in my heart. The impact in communities, the accessibility with on average 54 hours a week without an appointment must be maximised, and the profession is willing and able.

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