John Minihan (Progressive Democrats)

I welcome the Minister and compliment her on bringing this legislation before the House. The pharmacy profession has been waiting 130 years for it and it is delighted the Minister has seen fit to commit to enact the legislation soon.

Prior to being a Member of the House, I managed and worked in a pharmacy for seven years. In that time, I saw the vital role played by pharmacists and their unnoticed work in delivering our health care. Their knowledge of pharmacology and medications and their interactions with people with chronic illness are vital. Often, I despair at people's lack of knowledge about the role of a pharmacist, how he or she checks medications, interactions and side effects and how he or she counsels patients. For the pure pharmacists, those working in the community area, it is not a question of sales or profit. It is about providing an important service.

Pharmacists could keep a daily log of the number of times they must interact with general practitioners to correct prescriptions. A pure retail business would be concerned with selling and bringing in money, not checking or interacting. In reality, a locum doctor might not be up to speed with a patient's medication and some patients do not disclose their medication. For example, they may not say they are asthmatics because they do not consider ventolin or becodite to be a drug. This would have implications for what the doctor prescribed, but when the prescription arrives at the pharmacy, the pharmacist, who has built a relationship with the patient, knows. He or she will contact the doctor and the prescription will be changed. If a log were kept by pharmacies, one would be amazed by the number of times the professional training and expertise of the pharmacist is exercised daily by spotting such irregularities.

With interest, I noticed how the role of community pharmacies has expanded in other jurisdictions. The legislation we are considering will provide a framework for developments in the public interest and will ensure that patients who interact with pharmacists on a daily basis will be protected. However, we must be aware of the points made by previous speakers regarding the situation in Europe. The removal of the derogation will be of benefit to the many pharmacists trained outside this country, but an Irish pharmacist is not allowed to open or operate a business in other jurisdictions. We must level the European pitch.

A traditional feature of community pharmacy is the personal relationship between the patient and the pharmacist, which is based on trust, confidence and historical association. It is important to keep the connection. Like previous speakers, I am concerned about the relationships developing between pharmacists and health centres. It is seldom that I agree with anything Senator Ryan says, but his point on health centres was vital. There must be a clear distinction between the pharmacist's role as the dispenser and the prescriber's role. If one pays significant money, be it key or rental money, to a prescriber upstairs, one is being driven by profit and turnover. That is not what we want from pharmacists because it would not be in the interest of the patient or the public.

Whatever amendments are to be tabled, they will prop up the Bill and prove how successful it will be. We must ensure there is patient safety, regulation and no associations. We have all heard of examples and it works both ways in certain cases, but there cannot be any association.

We have to consider the community pharmacies throughout the country. Everybody talks about the profits being made by people, but it must be understood that more than 75% of the drugs which are dispensed through the general medical services scheme are paid for by the State. When one considers that under the drug payment scheme, the State pays everyone for expenditure on medicines in excess of €85 a month, it is clear the State probably pays for between 85% and 90% of drugs. We often hear about the profit margin of pharmacists on the private dispensing of medicines, but they make no profit on drugs which are dispensed under the general medical services scheme. Those drugs are dispensed at cost price, with a dispensing fee. It is a misnomer to suggest otherwise. The 2005 figures for the income earned by pharmacists from dispensing fees are interesting. Some 23% of pharmacists earned less than €60,000 in that year and a further 27% earned between €60,000 and €100,000. There is a myth about the earnings of pharmacists, particularly in the communities.

We have to be careful to protect the link between community pharmacy and patients. I was somewhat disappointed to note that the Bill refers to "retail pharmacy". I would be much happier if we referred to "community pharmacy" rather than to "retail pharmacy". That is one of the many issues I will raise on Committee Stage. The term "community pharmacy" reflects better the role played by such operations. It makes a distinction between community, hospital and industrial pharmacists. The Competition Authority has a role in this regard. Over many years, I have pointed out to those involved in the pharmacy profession that politicians, legislators, the media and the Competition Authority view them as retailers rather than professionals who play an integral part in the delivery of health services. We have to get the right message across. The profession has endeavoured to do that in recent years by informing politicians and the public of its unique role.

I hope we can turn the tide by developing a fantastic relationship between pharmacists and the Health Service Executive, which can provide many services. The amount of contact between the public and the health profession is not more than the amount of contact between the public and the pharmacy profession. Each person visits a pharmacy 20 times a year, on average. The connection between pharmacists and the people should be used properly in areas like screening and medical advice. Advances have been made in many parts of our medical regime, such as the manner in which medication is managed. It would be in the greater interest of the HSE to view pharmacists as professionals, to avail of their services and to use their contact with the public to develop various aspects of the health strategy.

I would like to speak briefly about the role of pharmacists in society. While I welcome the Minister's proposals in this regard, she should ensure that language proficiency is to the fore in the new fitness to practice system. We can ensure that pharmacists have qualifications, examinations and certificates, but we should also ensure they can communicate. If they cannot do so, they will be driven back to the dispensary upstairs or in the back of the shop, which is not what we want. Pharmacists should be in the front of the shop, where they can deal with customers and patients by advising them about drugs. If they are not proficient in the English language, will they be able to provide the advice and service we need? I accept that Senator O'Rourke's Spanish pharmacist might be very welcome in Athlone.

It is important that this legislation provides for a means of disciplining pharmacists, when necessary. Similar provisions are part of the regulatory systems of most professions. As we saw in the Shipman case, which has been mentioned, and the Neary case in this country, havoc can be created within a profession by the deeds of just one person. It is important that pharmacists who do not practice properly are subject to disciplinary proceedings of some type, if necessary.

I welcome the Minister's intention to introduce an amendment pertaining to the relationship between doctors and pharmacists. I hope the amendment will be made as soon as possible. It is most important that we get this aspect of the legislation right. I mention this issue because it is important that we maintain the traditional clear distinction between doctors and pharmacists. I welcome the Minister's decision to take on board the recommendations of the Government's pharmacy review group. We should bear in mind that if we do not get this aspect of the legislation right, we will do a disservice to this tremendous Bill.

I compliment the Minister for Health and Children and her officials. I know she made a commitment to the pharmacy profession to introduce this legislation. She said she would endeavour to have it enacted before the general election. I hope Senators will facilitate its early passage through the House. The members of the profession have given a broad welcome to this Bill, which is long overdue. They have quite successfully lobbied a number of politicians to raise some valid questions on Committee Stage. I look forward to the Committee Stage debate, when I am sure we will work through the various issues.

I am concerned about the training of over-the-counter pharmaceutical staff. People do not fully appreciate that a great deal of the medication which is sold over the counter is rightly restricted to pharmacies. A Senator spoke earlier about runs on codeine and similar products. When I worked in the retail pharmacy sector, I saw such runs coming up. It is vital to ensure that staff are trained properly. In fairness to the pharmacy profession, it ensures that its over-the-counter staff are trained to certain standards but I would like that to happen on a more professional basis.

I await eagerly the Committee Stage debate, when many issues will be raised and all aspects of the legislation will be considered in detail. I look forward to considering the amendments that will be proposed by the Minister, Deputy Harney. I hope all Senators will support the early passing of the Bill by this House, which will allow it to be sent to the Dáil and enacted before the forthcoming general election.