Mary Harney (Dublin Mid West, Progressive Democrats)

I will discuss the matter with my officials to ensure, in so far as possible, we can put right what may be a difficulty. It is generally the case with legislation that we "grandfather" either premises that do not fit modern requirements or perhaps qualifications and give people periods of time in which to meet the standard, which is reasonable. I will check the position in that regard with my officials.

When I was growing up, my family availed of the services of a single chemist. I suspect that my parents, who migrated from Galway to Dublin, frequented his shop because he was a native of Galway. My memory of him is one of a man who worked extraordinarily hard seven days a week. I told this story recently in respect of doctors and many of them were of the opinion that I was suggesting that they should work 24 hours a day, seven days a week. However, I was not suggesting that.

People receive extraordinary service from their pharmacists. The latter are professionals and are among the brightest individuals in the country. One must be extremely intelligent to gain entry to pharmacy school. Even with a second school, it is incredibly difficult for people to obtain a place. The position is similar for physiotherapists, occupational therapists, doctors and language therapists. We are attracting into the health care system the brightest people in the country. That is a fact.

Reference was made to the making of profits. From a philosophical and pragmatic point of view, I have no difficulty with individuals making profits. People would not be in business if they could not make profits. If there were no profits to be made in the area of health, most of the research that pharmaceutical companies carry out — worldwide, this work is 80% funded by such companies and 20% funded by governments — would not happen. A large amount of the money invested in research never sees the light of day. A higher percentage of research does not pass what is referred to in the business as level 3. In other words, it does not proceed to the next stage. The figure in this regard is rising all the time. If companies could not make money from products which succeed and which can be developed and commercialised, they would not be in the business.

I do not see the making of profit as a bad thing. I have just returned from a trip to Scandinavia. I was interested to learn that socialist governments there have brought in private companies to run the hospitals. If I was to suggest that we should follow suit, according to Deputy Rabbitte, all hell would break loose. I visited one hospital in Stockholm which brought in a private company and it has had extraordinary results. This is what governments are doing to seek to provide better services for patients. What motivates me is better services for patients.

No doubt those, whether doctors, pharmacists or whoever, who are well qualified and who work hard are entitled to a decent living, and nobody should begrudge that. Nobody is trying to stop that. What I want to ensure is fair competition. The sole reason there is a reference to the Competition Authority approving the code is to ensure that codes are not used as barriers to entry or in an anti-competitive way.

Obviously the Bill covers pharmacists wherever they practise. It does not deal with definitions, as I stated earlier, and it does not deal with the hospital setting, but if there is a complaint, records can be sought and all the powers contained in this Bill apply as much to a pharmacist working in a hospital as to one working in the retail community sector. For the information of Senator Minihan, we could not used the definition "community pharmacist" for legal reasons on the advice of the Parliamentary Counsel. I must inquire privately what the precise reason for this is and make him, and everyone else, aware of it. I am not certain what was the legal difficulty, but there was one.

When I originally took this Bill to the Government, it contained provisions on conflict of interest and property issues. The advice of the Attorney General, which as a member of the Government I am obliged to accept as he is the constitutional law officer of the State, was that we could not do it in that way because of property rights and a great many constitutional issues, and that is why we are doing it differently in the amendment I am bringing forward which I will be happy to circulate later. There is a real challenge in this regard. It is not easy to deal with the changing structure of the pharmacy sector. For example, we could not legislate for market share. That would be prohibited. Obviously, every pharmacy must have a supervising pharmacist and every corporate entity must have a pharmacist in charge of the overall corporate body. That is appropriate to ensure the provisions of this legislation apply.

I see the society as the regulator in the public interest. It is not a representative body in the way that people suggested. The society possesses advocacy powers and maybe that should be examined. I do not know whether the advocacy powers are related to patient safety, professional education or whatever, but it is not the union of pharmacists, which the IPU is. I compliment Senator Glynn on reading into the record of the House the submission of the IPU, which I am sure was gratified to know that its work was not in vain. I read it too, and we will be clarifying some of the issues of concern.

How long the admonishment would last, for one year, five years or whatever, is a matter for the society or, ultimately, a matter for the court because these matters may be appealed to the court. I must inquire whether the society can inform other regulators in other countries. I would hope it could but I want to check to ensure that is the case.

The nominees' term is four years. Perhaps it should be five. Four years is a rather short term and we might look at that. Clearly, the nominees are not political people. On the idea that a regulatory body would change if the Government changed, this is not the United States of America where everybody gets a position based on whether he or she supported the party in office. I think that is not a good system, certainly not in public bodies. It is a matter of inspiring public confidence in regulation and that is the reason I am so keen to introduce a lay majority. The other profession says such a situation does not exist anywhere else in the world, but I am delighted to see that the White Paper published in the UK two weeks ago states that the professions should not hold a majority and we are moving in the same direction. It is all about inspiring public confidence in regulation, which is very important.

The persons nominated by the Minister, or, indeed, by the Health Service Executive or the Irish Medicines Board, are not on the council to represent their nominator. The reason I included those bodies as nominators was to show that we are trying to get people who have something to offer and it is not a question of merely picking names off the top of my head or anybody else's head. I would be happy to include other bodies if people felt that they were appropriate to nominate to the society.

Clearly, the confidentiality rules that apply to the individuals nominated by the Minister apply equally to the people nominated by the HSE or the Irish Medicines Board. Often this is misunderstood. For instance, often I am asked in the other House what is happening at the Medical Council in particular inquiries. I am not informed. I have no right to be informed. It is entirely confidential. The Minister cannot interfere in the operations of the council and I know no more than anybody else knows. In fact, I read in the newspaper of its recent inquiry. I was not informed of it officially. The council did not have any such obligation, nor should it. The council acts independently and the same will apply to the pharmaceutical society.

Clearly, if I, as Minister, have concerns, I will bring them to the attention of the regulatory bodies, just as I have done to the Medical Council in some issues. If there were issues I felt the regulatory body should address, I would bring them to the society in my capacity as somebody with responsibility for health, but not as somebody who was trying to interfere in the day-to-day activities of the council.

We will provide in the legislation that there must be a separate entrance to a pharmacy. I take the point that this should not give rise to a duty-free type scenario. Although that may be the case in Dublin duty-free, it is not the case in other countries where one may happily go from the entrance to an airport into one's plane without walking through duty-free. I take the point made and we are making an amendment in that regard.

The society will be able to deal with a matter about which it has had considerable concern for quite some time, that is, underperforming pharmacists. Clearly, the issue of competence assurance is not as developed as I would like. It is an area on which we need to work together. It is certainly not as developed as the medical profession in medical regulation, but the days of a professional qualifying and practising for his or her entire working life without continuing education are over. It will be a matter for regulators to ensure this is the case because matters, and especially those in the area of medicine, change rapidly.

How one regulates for the Internet is an issue that concerns governments across the world. If somebody can tell me how I might be able to regulate for the Internet, I will be more than happy to do so. Some things are not possible.

MRSA was mentioned. I refer again to my visit last week to Norway, Denmark and Sweden, all of which have a good MRSA record. On the MRSA map produced recently, they are in the green zone which is the good zone. Ireland is in the red zone and there is an orange zone between the green and red ones. There are two issues that affect MRSA. Antibiotics is by far the largest one and we in Ireland have an obsession of going to the doctor looking for antibiotics. The number of people I meet who are on antibiotics for something as simple as a head cold is incredible. It will take quite a long number of years, perhaps 20 or 25 years, for us to change that. We must involve pharmacists and doctors in a national effort. Patients must also be involved because if they go to the doctor and do not get a prescription, then they feel the doctor is not quite interested in their ailment.

The other issue is personal hygiene, hand washing, etc., between attending patients. In Sweden, for example, doctors rarely wear ties because of the difficulty of it touching the patients and picking up all kinds of infection, and they all wear their uniforms. I understand they do not wear their uniforms to the supermarket. I am not saying the doctors here do but I frequently see health care workers in their uniforms shopping in the supermarket. If we in Ireland want to reduce the incidence of health infections, especially MRSA, we must deal seriously with these crazy practices. As Members will be aware, one third of us in this Chamber have MRSA. I will not specify which third but that is the statistic.