Colm Burke (Fine Gael)
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I welcome the Minister. The matter I seek to raise is a follow-up to a presentation made by the Irish Pharmacy Union at a recent meeting of the joint committee. It concerns a new medicine service. This applies to people who have a long-term illness but have been prescribed a particular new medication. It has found that people who experience complications are reluctant to go back to their GPs. Pharmacists are offering to provide a follow-up service where the person could come back to the pharmacy within a three to five day period, to ensure that the medication prescribed is working and that they do not have difficulties with it, and if difficulties arise they will be dealt with at an early stage. As the Minister is aware, there is a complaint about medication being prescribed and not being properly used. When this happens with older people, there is a need for a direct connection between the pharmacist and those who have prescribed the medicine. The Irish Pharmacy Union is talking about providing this service as a follow-up service which would be put in place once the person has been prescribed the medication.

Leo Varadkar (Dublin West, Fine Gael)
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I am responding on behalf of my colleague the Minister for Health, Deputy James Reilly, and thank the Senator for raising this important issue.

I refer to the current approach underpinning the delivery of community pharmacy services in Ireland. The supply of prescribed medicinal products to eligible persons by community pharmacists is governed by the terms of the 2007 community pharmacy contractor agreement. Clause 9 of the agreement provides that prior to dispensing a prescription, a community pharmacy contractor must ensure that a pharmacist reviews the medicine therapy of the individual for whom the prescription is issued. The review shall include screening for any potential drug therapy problems which may arise out of the use of the medicines prescribed, including therapeutic duplication; drug-drug interactions, including serious interactions with non-prescription or over-the-counter medicines or food; incorrect dosage or duration of drug treatment; drug allergy interactions; and clinical abuse and-or misuse.

The review shall also include an examination of the rational and cost effective use of the medicine prescribed, including the choice of the medicine and the potential for wastage. Following the completion of the review the pharmacist shall offer to discuss with the individual for whom the prescription was issued all such matters as the pharmacist, in the exercise of his or her professional judgment deems significant, including any special directions and precautions for correct preparation, administration and use of the medicines; the importance of compliance and the directions for use; any common severe side-effects and adverse reactions or interactions and therapeutic contra-indications that may be encountered, including their avoidance and the action required should they occur; techniques for self-monitoring during therapy and the need for patient compliance; prescription repeat information, as necessary; and, as necessary, any other matters which may be included or referred to in the patient information leaflet supplied with the medicine.

The existing community pharmacy contractor agreement, therefore, provides that pharmacists deliver a comprehensive on-going support service to their patients in terms of ensuring they are fully informed of all issues pertaining to their prescription medicines However, as Senators will be aware, the Government has embarked on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance, where access is based on need, not on ability to pay. Implementation of the Future Health: A Strategic Framework for Reform of the Health Service 2012-2015 document is a priority for Government in this context. Delivering on the Government's goals in primary care will impact on primary care health professionals, including community pharmacists. As part of implementation of Future Health, pharmacists will be expected to identify and contribute to implementing evidence-based and cost-effective solutions to ensure the effectiveness and sustainability of the healthcare system, by addressing key medication issues such as medicines wastage, inappropriate usage of medicines, supporting and improving chronic disease management and patient adherence to medication. The Minister for Health looks forward to working closely with pharmacists who will have an important role to play in delivering on the goals of Future Health.

Colm Burke (Fine Gael)
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I thank the Minister for the comprehensive reply. The reply deals with the obligation on pharmacists to discuss the medication when a person calls to collect the medication. There is no obligation under the present procedure for the pharmacist to provide a follow-up service. That is what the pharmacists' union is saying. It is saying pharmacists can play a very important part in making sure the follow-up service is there and there is a provision that the person can call back to the pharmacist within a five-day period to discuss any issues that arise with the new medication. That is what pharmacists are saying is worth doing. They are referring particularly to people who are prescribed medication for the first time on which they are likely to remain into the immediate future. Pharmacists are looking for this procedure to be put in place with the HSE and that it would be a co-ordinated approach involving doctors, pharmacists and the HSE.