Pearse Doherty (Sinn Fein)

I welcome the Minister, who has at long last come before the House to discuss this issue. A Senator from the Government benches wondered whether we are rushing under pressure or have been lobbied intensively to speak on this issue. I was the first person to speak on this issue in the Seanad and since the resumption of the Seanad and Dáil last year Sinn Féin has called on the Minister to deal with this critical issue, which has escalated in its threat to community pharmacies. It is only now, after the cuts that have been imposed, that there are statements and questions on these matters. A similar situation has arisen in the Joint Committee on Health and Children, which dealt with this matter in detail and met over three days to hear submissions, followed by questions and answers, from the HSE and the Irish Pharmaceutical Union. The committee requested that the Minister attend these hearings before 1 March but she did not do so. I believe the Minister shirked her responsibilities and sent a negative signal to Senators and Deputies who represent their constituencies. She is hiding from this issue and is avoiding her accountability to the Houses of the Oireachtas.

The escalating pharmacy dispute has been a cause of concern for tens of thousands of patients. Not only have pharmacists contacted Members of these Houses but we have also received calls from patients worried that they will not receive service if their pharmacies withdraw from the general medical service, GMS, or the drugs payment scheme. Last week 475,000 letters were handed in to these Houses but they were allowed in at a rate of only five at a time. The figure shows how many people believe the Minister is doing the wrong thing on this issue.

This matter has caused concern for all users of our health services, whether medical card patients or those dependent on the drugs payment scheme. I have seldom seen an issue that led to such prolonged lobbying of TDs and Senators, yet hardly featured in the media. This is unfortunate because if this matter received the media attention it deserves it might have been resolved before now.

There is no doubt the most aggravating factor in this dispute has been the adherence of the Government and the HSE to the line that they cannot negotiate financial issues with the IPU, allegedly because of the Competition Act. Many Senators spoke of the Competition Act and the Minister and the Government have hidden behind it without attempting to address this piece of their own legislation. They opposed the Competition (Amendment) Bill put to the Dáil by Deputy Michael D. Higgins in recent weeks and I do not believe they are sincere in their efforts to resolve this issue and negotiate with the IPU on financial matters.

If the IPU withdraws from the medical card and drugs payment schemes tens of thousands of patients will be affected. The HSE tells us that only a few pharmacies will withdraw from these schemes but this remains to be seen. I hope no pharmacy withdraws from them and I appeal to all of them to continue their services because patients will be affected by such a withdrawal. The IPU is to meet tomorrow and as a result pharmacies across the State will close. The IPU is to be commended on organising an emergency service, but in Donegal four pharmacies will remain open for three hours each. That amounts to four pharmacies in a county where it takes two hours to travel from one to the other. In their need to avail of pharmacy services tomorrow, patients will see the long-term effects of the decision of this Minister, which will close rural pharmacies that are not viable and that depend on the medical card scheme. In my county 80% of patients who visit pharmacies hold medical cards.

The Department has received e-mails on this matter. Some pharmacists are asking the Minister and the Department to run the numbers they are offering pharmacies, audit their accounts, and tell them whether they will stay in business under such terms. I welcome the extension of the deadline to 1 March on the cuts imposed by the Minister but there is no point extending a deadline if nothing is to happen in the period before it is reached. There should have been meaningful negotiations during this period, involving the independent body, to review the pricing of medicines for pharmacies. There is no point having negotiations now if the cuts are to be imposed anyway. I fear the decision some pharmacies will take on 21 April, the day pharmacies across the State will receive payments for drugs issued at the reduced prices.

This issue is all about patients. Across the State, in rural Ireland and particularly on the west coast, the effect of the closure of post offices can be seen. One day in January five post offices closed in rural Ireland and I have no doubt that if the Minister continues with this scheme we will see the same type of effects. They were not evident on 1 March and will not be evident on 21 April but will happen drip by drip. This is not good for patient care, services or rural Ireland.

The IPU uses its figures to claim that more than 300 rural pharmacies will be the worst affected. Age Action Ireland is very concerned about this matter because older people in areas with no public transport will be forced to travel long distances for medication.

I ask the Minister, even at this late stage, to enter meaningful negotiations with the IPU on all of the issues involved in this matter, including pricing. The president of the IPU called on all pharmacies to maintain services and this shows real leadership while some pharmacies are threatened with going out of business. I ask the Minister to meet pharmacists' representatives, enter meaningful negotiations, defer the cuts introduced in March and allow the independent body to review the pricing mechanisms in order that she can deal with this in a more considered way.

The Minister has tackled this issue in a ham-fisted way. There was an iron lady in Britain in the 1980s and there is no desire to replicate her in this country. I ask the Minister to take a more compassionate, considered approach to this matter. The media have not picked up on this story, unfortunately, because it is complex and while the HSE says one thing the Department says another and the pharmacies another. Everything is revolving around notions such as the 17% and the 8% and the overall cost of medication.

My young son is on medication that costs €40 at the local pharmacy. A couple of miles across the Border, in Derry, the same medication costs €5? Who is responsible for this? This is not a 17% increase but is a result of prices set by the Department of Health and Children and manufacturers. I welcome that we are examining savings that can be made in the health service and are seeking to reduce the cost of medication to the general public. However, I ask the Minister to accept audited accounts from pharmacies and to run the figures on what they are being offered. Will she come back to the House and confirm, on the basis of those audited accounts, that those pharmacies will remain in existence? If not, will she confirm that her decision and that of the Government will result in the closure of rural pharmacies and that she stands over that?