Victor Boyhan (Independent) | Oireachtas source

This is very progressive legislation, so I can confirm that I will be fully supporting all aspects of it. The rent-a-room scheme is clearly an issue in terms of medical card criteria. I would have some concerns about the scheme but this is not the Committee on Housing, Local Government and Heritage. Someone rocked up recently and said to me "The person across the road can take €14,000 and a whole set of circumstances, and I'm not in the same position" but that is a matter for debate at another forum. We have to have equity across housing delivery in terms of rent. That is not a matter that I will burden the Minister with at this time. I recognise that it should not affect medical cards. We are in a housing crisis and there are many benefits to having people who can live in houses - whatever the arrangement is - so it is all very positive. Clearly, we do not want to prevent people from having access to full medical cards where they are entitled to them. I accept and acknowledge that.

The expansion in the role of pharmacies is the issue on which I wish to concentrate, because it is important. I acknowledge that the Minister established the task force. There was an interim report, a summary of which I have in front of me, in November 2023. As the Minister confirmed to us today, the final outcome is due shortly. I acknowledge the calibre of the people on the task force because that was really important. The remit of the task force was to identify and support the delivery of specific objectives that would serve to align services and practices that can be delivered by pharmacists and pharmacies with the needs of the health service for patients. That is important.

As I read it, the kernel of this legislation is to empower pharmacists to offer prescriptions and other ancillary services. That is important. The Minister and the task force have placed a heavy emphasis on the safety of people and patients who use medicines. That is reassuring. High standards of governance are dealt with by the task force recommendations to the Minister. Again, this is important. These are the reassurances we must give patients and the people who use our community pharmacies. I like to see the "community" appear before "pharmacies". That is really important. I can walk into my local pharmacy in Dún Laoghaire and talk to a qualified pharmacist. I do not have to go around the back. Pharmacists are dispensing at the coal face. There are concerns and complications, and patients need reassurance. Patients may have an allergic reaction. They have genuine concerns. Our community pharmacists are almost community workers. They do many things and allay many fears. They interface with patients who may present with mental health issues, including anxiety. They may suggest alternatives for people or suggest that they need to go back to their GPs because they have on a particular medication for what may have been too long a period. There is a good, well-established relationship with pharmacists who work in communities, which is important. The Minister spoke about high standards of governance. Regarding access to expert patient advice and advocacy, that is what pharmacists offer. Qualified pharmacists are very experienced and capable people.

The legislation deals with safety, quality and the efficacy of medicines in pharmacies, which is important. It is a very better use, as the Minister said, of healthcare resources. That is a really valuable point. People do not need to go back to their GP and pay €75 for a top-up prescription after three months. If a GP sees that as significant or important, he or she can write that on the notes. We see how technology has developed. Most GPs dispense prescriptions directly to pharmacies, so we see a consistency of relationship in the context of pharmacies, GPs and the medicines being prescribed. We see less of patients going to a number of different pharmacies, which is a good thing.

The Minister mentioned the key role of the pharmacy regulator. For those who may have concerns about this legislation, pharmacies are clearly subject to oversight by the pharmacy regulator, which is important. I have touched on the expert task force supporting the expansion of the role of pharmacies. I acknowledge the meaningful role of pharmacists and the owners of pharmacies. Many pharmacies are now owned by groups, but we still have strong family pharmacies, which is quite unique because you do not see many of these on the Continent anymore.

Community pharmacies play a unique and important role and this is important because it is a patient-centred approach. Sláintecare spoke about this before and the significance and role of pharmacies within a module of Sláintecare. We must constantly keep chipping away at Sláintecare. I know the Minister is committed to Sláintecare. It is important that we acknowledge the high quality and expertise of the cohort of healthcare professionals who are very knowledgeable in this area.

I know someone who on 13 May graduated from the pharmacy technician course. The ceremony happened at the Royal Dublin Society down the road from here. It was organised by the Irish Pharmacy Union. There is a valuable role for pharmacy technicians. Being a pharmacy technician is a career in itself. They are at the coal face in pharmacies, which is important.

I take this opportunity to thank the Irish Pharmacy Union. It publishes a magazine on a regular basis. Every Member of the Oireachtas receives a copy. It contains a section on the contributions of Members, so no doubt we may very well be featuring in it soon. If not, I am prompting that here and now. It is a really good and educational magazine. I certainly learn a great deal from it. Community pharmacies are very important.

The measures relating to patient safety, notification of incidents and open disclosure are really important. I welcome them. I also welcome the fact that there is a technical amendment in this regard. The Minister covered that. I welcome the amendment, because it is significant.

The final issue I want to discuss relates to community pharmacy fees. The Minister has been honest and frank enough, as he always is, that there will have to be some discussion about this matter. I am not saying he has given a commitment, but he has listened. Clearly, this will be an issue. Given that the Minister has put us on notice, all we can say is that we must be sensitive when it comes to fees. Pharmacies are businesses. If they providing additional services, clearly someone has to be paid. However, it is important that we are kept briefed about that as the negotiations with pharmacies evolve. When someone is unwell and has health issues, he or she is vulnerable for a variety of reasons. When people talk about fees, and, in fairness, we have a very good medical card system, they get anxious about increases.I will finish with the point that I visited an elderly person the other day whose GP has prescribed paracetamol, a whole box of pills. I asked her why she had got all of them and she told me the pharmacy says she has to take them. Why has this person got 700 or 800 pills she is not using? The answer is the prescription said so. That is a real concern and we need to get the word out to GPs about boxes and boxes of paracetamol. People can say that if they pop three or four of them a night they will sleep well. The pharmacy is of course not going to turn down the business because it is on the script. We have to be constantly careful. We must be vigilant about how we monitor the levels of particular drugs and where they are being prescribed. There is a league table kept of all the GPs in the country, and I am sure consultants too, and we can see very high prescription rates in certain parts of the country and very high prescription rates with certain doctors. Popping pills is not the answer. Good healthcare is holistic in nature and covers a whole range of issues. I am concerned because I have come across it quite a lot that people are continuing to have all these add-ons and they are costing the taxpayer and costing people. It is not good for us where our taxes are concerned, but more importantly it is not good for the healthcare of the individuals for whom these are being prescribed. What do people do with the excess medication in most cases? They hand them around to their neighbours, which is not very satisfactory. We need to be vigilant. I thank the Minister; he has my full support.