Frances Fitzgerald (Fine Gael)

I welcome the Minister to the House. There have been many calls in recent weeks for her to come to the Seanad and to explain the action she has been taking. The reason Members on all sides wanted her to come was because of the concerns of the pharmacy sector. These concerns focus mainly on the risks to the community pharmacy sector. Pharmacists say that many pharmacies could close because of the changed economic situation which they face. They also say that many people who are new to the profession will find it difficult to survive.

There is a wide range of concerns on all sides of the House and Members would have welcomed an opportunity to discuss them with the Minister before the deadline of 1 March. I regret the Minister chose to come to the House after the deadline had passed. It does a disservice to the Seanad, following the disservice done to the Dáil when she chose to appear before it as late as last Thursday. If democracy is to mean anything, Parliament must engage in vigorous debate and discussion of issues. Instead, representatives of the Health Service Executive appeared before a committee of the House to defend the organisation's decision and stated the HSE was carrying out political orders. We did not hear the details from the Minister. The HSE defended her policy and she chose not to explain, defend or debate the changes she was introducing in either House.

As usual, the Minister strongly defended her stance. She indicated that she has taken into account broader health issues and the cost of drugs. No one disagrees with her argument that drugs should be cheaper and profit margins need to be examined. The Indecon report, which examined margins, noted the difficulties in making the type of international comparisons to which the Minister referred.

The Minister is presiding over a failure in industrial relations. Those working in the pharmacy sector, which provides a good community service, are very concerned and alienated. They believe a confrontational approach has been taken, they were not involved in meaningful discussions about the changes and efforts were not made to bring them on board. Time and again they have indicated that they accept the need to reduce costs. They have also made a range of suggestions for making cost savings and recognise wastefulness in the dispensing of medicines. Clearly, therefore, there is scope for agreement and discussion.

Having established an independent body, why did the Minister not remove the deadline? Why did she not engage in discussions to reach agreement on a range of measures to be taken to secure the cost savings she seeks to deliver a better health service? We are aware of the many deficits in the health service, realise that money is needed for many frontline services and accept that savings should be made in the area of drug prescribing. However, the manner in which the changes have been implemented is disturbing.

Many people are concerned about the impact of the changes on the fabric of community life. There has been considerable discussion in the media and elsewhere about threats to the fabric of community, especially since the violent killings last week of two young Polish men. While that incident may appear to be far removed from the issue under discussion, the role of the pharmacy in delivering local services to vulnerable people in communities has emerged in this debate. Post offices, for example, are closing and the fabric of rural life is under threat.

A letter from a pharmacist published in today's edition of The Irish Times states:

The HSE action will result in the community-based service being available only in large urban centres operated by Boots, Tesco or Unicare. The Minister won't say it publicly but this is what she wants because her HSE advisers tell her the large multinationals can absorb the costs. Meanwhile, a fine body of caring, frontline, professionals who have been providing a service, quietly and efficiently, to generations are put out in the cold.

Regardless of whether the Minister likes it, this is how pharmacists view the impact of the changes. They believe the Minister is supporting large multinationals without taking into account the concerns of smaller pharmacists, community pharmacists, the independent sector and those pharmacies with a large cohort of medical card customers. I ask the Minister to respond.

All sides, not only the Opposition, are concerned about this issue. Many Members on the Government side have expressed concern about the manner in which the HSE has acted. I refer to another letter published in The Irish Times on Saturday, 1 March, which noted that the HSE acted "without any consultation." It added: "If the changes go ahead as scheduled, the implications for our national delivery of pharmaceutical services will, in my view, be catastrophic." These words were not written by an Opposition politician but by a former Minister of State at the Department of Health and Children in the previous Government, the Minister's party colleague, Mr. Tim O'Malley. The Minister stated in the Dáil that Mr. O'Malley is a pharmacist. He raised the concerns I have raised about the future of small, local pharmacies, especially in rural areas. Will their future be threatened? If so, where are their patients, particularly elderly people, expected to go to obtain prescribed medication? Will the Minister outline what contingency plans have been made? She indicated that only 300 calls had been made to the helpline. That is a significant number of people raising concerns about whether their medication will be available. I expect many of the calls were made by elderly people.