Déirdre de Búrca (Green Party)
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Will the Minister of State clarify what contingency plans the Health Service Executive has in place should pharmacists withdraw from dispensing as part of the community drug scheme, as they have threatened to do from 1 May? I know this issue was raised with the Minister during the previous debate on patient safety, which was appropriate, and during her response the Minister made several references to her belief that it would be unethical and unprofessional of the pharmacists to withdraw from the dispensing of such services, especially given that a number of what can be considered vulnerable people avail of this service, including the elderly, people with disabilities, people with chronic health conditions and people who suffer from drug addiction. While I respect the Minister's belief that any threatened withdrawal from such a scheme would be unethical, it appears certain pharmacists are determined to proceed. There is much concern among members of the public that this will happen and that there are no contingency plans in place. I put down this Adjournment matter to establish what contingency plans the HSE has, or intends to, put in place so there will not be negative consequences for those to whom I referred who avail of the community drugs scheme and who would be in a very difficult predicament if left without this service.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Senator de Búrca for raising this matter as it provides me with an opportunity to outline the current position on this issue.

The Health Service Executive has operational responsibility for the management and delivery of health and personal social services under the Health Act 2004, including the provision of medicines under the community drugs schemes.

The executive has been reviewing the pharmaceutical supply chain with a view to seeking value for money in the State's drugs bill to better fund existing and innovative therapies without compromising patient safety or continuity of supply.

Following the completion of public consultation, and informed by the independent economic analysis carried out by Indecon Economic Consultants, new wholesale pricing arrangements were announced by the HSE on 17 September last. The report by Indecon was published by the HSE on 13 November 2007. All aspects of the Indecon report were considered by the HSE in making its determination.

In response to demands from community pharmacists to address the alleged impact of the new wholesale pricing arrangements, the HSE has offered a voluntary interim contract with a flat rate dispensing fee of not less than €5 for all dispensing under the GMS and community drugs schemes.

The Minister has established an independent body to assess an interim fair community pharmacy dispensing fee to be paid for the medical card scheme, the DPS and other community drug schemes. This body is being chaired by Mr. Sean Dorgan, former head of IDA Ireland. It has been asked to make its recommendations by the end of May 2008.

Both the HSE, as the contracting body, and the Irish Pharmaceutical Union, as the representative organisation for community pharmacists, along with other stakeholders, are entitled to make submissions to the independent body. I understand the Irish Pharmaceutical Union has made a submission to the independent body. The Government recognises the IPU as the representative body for pharmacists and wishes to maintain its long-standing relationship with the union as a key stakeholder in health care.

The HSE has reported that it has, to date, received notification from 400 community pharmacy contractors indicating their intention to either cease providing services from 1 May 2008 or otherwise reserving their right to do so. Community pharmacy contractors are required under the terms of their contract to give three months' notice of their intention to withdraw. The HSE has written to each of the 400 contractors seeking formal confirmation of their intentions and pointing out that three months' notice of cessation of service is required. At this point only two contractors have given formal notification of termination in accordance with the requirements in the contract.

The HSE has developed a national contingency planning framework which will inform and provide direction to local operational management for the development of local area-specific contingency plans. As service provision, geographical and demographic circumstances will vary from area to area, each local health area is developing its own area-specific contingency plan within the context of the overall national framework.

Threats of withdrawal from the community pharmacy contract are unjustified and are not in anyone's interest. The Minister does not wish to see any patient inconvenienced in any way and expects community pharmacists to fulfil their professional obligations under the terms of their contracts.

Déirdre de Búrca (Green Party)
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I thank the Minister of State for her response, although I did not find it very satisfactory. I deliberately avoided getting into the substance of the pharmacists' dispute with the HSE and focused very much on the contingency plans. Only one paragraph in the response dealt with that and it did not provide much information. I suppose it made me aware that the HSE has a national contingency planning framework but that each local health area will develop its own area-specific contingency plan within the context of the overall national framework.

I have not been left much the wiser as to what exactly the contingency plans are. I would like a little more reassurance in this regard. Much of the response was dedicated to explaining the HSE's position in terms of why it made the decision to reduce the dispensing fee for the pharmacists. I would like a little more clarity on the contingency plans.

Máire Hoctor (Tipperary North, Fianna Fail)
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I share Senator de Búrca's concern. We have made this known to the Minister and to the HSE. We are very anxious to see positive negotiation and discussion take place between the IPU and the HSE. I assure the Senator I will keep her informed of developments.