Fiona O'Loughlin (Fianna Fail)
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Thank you, a Leas-Chathaoirligh, for choosing this Commencement matter and I thank the Minister of State at the Department of Health, Deputy Rabbitte, for coming to the Chamber to discuss it.

Earlier this week, I met some pharmacy owners in my constituency in Kildare and I was quite shocked by what they told me about the major issues they are facing in terms of having pharmacists in their premises. Every pharmacy is legally required to have a qualified pharmacist on the premises for filling prescriptions and so forth. The main issue the pharmacy owners raised with me is the crazy bidding war that now takes place when they seek locum cover. Many pharmacy owners are forced to use a website called Clarity Locums to book a locum pharmacist. Last minute bookings through this site can see hourly rates rise to €150 per hour. One person I spoke to was paying €149 per hour.It is so lucrative that many pharmacists are walking away from full-time jobs and working as locums. They see far greater financial outcomes from that.

This is absolutely unsustainable and these practices further inflate the crisis facing the sector. We need to see the Department intervening here. There are four different areas where I will suggest action but the Department must take concrete and targeted steps to support the industry. I know now of pharmacies that have been forced to reduce their opening hours because of a lack of available pharmacists or the sky-high hourly rates that must be paid. Pharmacies are an essential public service and so many people right around the country in our local communities rely on them. We must support that service.

We must see action by the Department to aid recruitment into the sector. It is my understanding that many non-EU pharmacists cannot work in Ireland because their pharmacy degrees are not recognised here. They need to study for a further year to 18 months in order to register as a pharmacist. I know the Minister of State is doing much excellent work in supporting Ukrainian refugees coming here and many of these are very highly qualified people in the area of health, pharmacy, medicine, etc. I honestly believe there should be a derogation for those who are qualified and come here.

It is possible to declare retail pharmacy as a critical skill shortage. I read a report that the UK Home Office did in March this year on speeding up the process of registering EU and non-EU pharmacists. It is something we must definitely do because the process here is very cumbersome. Retail pharmacies could also be allowed to sell non-prescription medication without the presence of a pharmacist. Otherwise we will see pharmacies closing early or not being open for bank holiday weekends or even ordinary weekends, as they are now.

In the longer term, we must have an increase in the number of Irish university places for the pharmacy sector. Currently, there are only 240 per year and we have been outsourcing pharmacy education to the UK and other areas. They are now having problems with recruitment as well. We must also have a new pathway for experienced pharmacy technicians to become fully qualified. That should be considered. There are a number of areas here and the issue crosses higher education and retail. That is the crux of the matter. I look forward to hearing the Minister of State's response.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Senator O’Loughlin for raising this matter, which I am taking on behalf of the Minister for Health, Deputy Stephen Donnelly.

The Minister is fully committed to any and all actions, underpinned by meaningful engagement, that might mitigate any challenges arising in the context of health workforce availability. The Senator has outlined the various challenges affecting pharmacies in particular, which are an essential service. Pharmacists are required on-site at all times to provide the service. I am taken aback to hear of a bidding war for locums and the rates being paid. It would be far more lucrative to be on the WhatsApp group panel than having a full-time job from 9 a.m. to 5 p.m.

The invaluable contribution of the pharmacy sector and professional pharmacists over the last two years in an extremely challenging environment reinforced the importance of pharmacists in the healthcare system as a whole and the contribution made to patient and public health on a daily basis. The regulation of pharmacists in Ireland is provided for under the Pharmacy Act 2007, and the Pharmaceutical Society of Ireland, PSI, is charged with carrying out this role. The oversight and governance of the regulator is a matter for the Department of Health and my officials have engaged on the matter raised.

It is the Minister's understanding that the regulator is cognisant of reports of challenges that may be emerging in the availability of a pharmacist workforce. The PSI's corporate strategy for 2021 to 2023 contains an action for the PSI to "take steps to identify and mitigate risks to the continued availability of the professional pharmacist workforce, particularly within the community pharmacy sector". This has materialised as the PSI's Emerging Risks to the Future Pharmacy Workforce project, which is a multi-annual project due to run across 2022 and 2023.

In the PSI’s 2022 service plan, the project is set to "assess emerging risks to the continued availability of a professional pharmacy workforce within community and hospital pharmacy in Ireland", with this work currently at the scoping and planning stage. The Senator identified the issue and we cannot stand back. This process must be expedited. The PSI is to convene an expert stakeholder advisory group to advise and inform at key phases throughout the course of the project as to the key risks which are affecting and could affect the continued availability of a professional pharmacy workforce. It will also make an input into proposed strategies to address these. It is expected that proposals for the necessary next steps will be brought to the PSI council by the end of 2022.

That would be a welcome opportunity for the PSI to identify the gaps outlined by the Senator, including shortfalls in university places and opportunities for a technician to upskill. Perhaps that is something we can consider within higher education or the apprenticeship model. Ultimately, a pharmacist is legally required to be on-site and the doors cannot open otherwise. We do not want pharmacies closing in rural towns and villages because they cannot get a workforce. We certainly do not want people leaving hospital settings to be on a particular panel where they can choose their own hours and where to work.

The Senator has provided a shortcut for the PSI. The stakeholder group could start working as soon as possible. Perhaps it could lead to us having a proper plan even for next year's school setting.

Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State. I have no doubt she understands the position. She understands how critical the issue is. It is good to hear about the project that is in place and the scoping exercise but, honestly, it is far too late for that. This is a crisis and if the Government does not act, we will see community pharmacies cutting hours and not being open at crucial times. In rural areas, as mentioned by the Minister of State, the footfall is not as high as in urban areas so it can be very difficult for a business to be sustainable, which it needs to be.

This must be absolutely addressed urgently. We have thousands of highly qualified and skilled refugees arriving to our shores from Ukraine. We must look at the existing legislation to see how we can circumvent red tape and have these people working in our pharmacies. This is not just about the pharmacy sector but GP practices, primary care services and right across our health service. It is very important and we would see mutual benefits as well. The regulator must step in to address the website issue I described. The registration of pharmacists is very important and the project described by the Minister of State must be expedited.

Anne Rabbitte (Galway East, Fianna Fail)
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I completely agree with the Senator that the crisis is now. We must address it now. There is a role for the PSI in stepping forward and we should not let the target of the end of 2022 for that process to be completed be the goal. The goal can be now and the organisation can address the matters identified by the Senator. There is also the opportunity to engage with a workforce coming this way and we should have the criteria to assess qualifications so we can have the opportunity to engage persons who want to work with us. We must consider that now and not in six months. If we do not address the problem now, there will be pharmacies closing in rural Ireland when we need that vital and essential service.