Seanad debates
Thursday, 23 February 2023
Nithe i dtosach suíonna - Commencement Matters
Pharmacy Services
9:30 am
Robbie Gallagher (Fianna Fail)
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I welcome the Minister of State to the House to discuss the role community pharmacies could have as key players in providing healthcare to our communities. We are all aware of the pressures experienced by many GPs across the country. GPs are oversubscribed, we do not have enough GPs and people cannot get added to a GP list. We are well aware of this issue in many parts of the country, including in my own county of Monaghan, where many young people who moved back from college or whatever are finding it difficult or impossible to get a GP. Unfortunately, the age cohort of our GPs is also increasing. In emergency departments, people often have to wait long times for treatment. In many cases, both GPs and patients could be seen safely and more suitably elsewhere, according to many pharmacists. I welcome plans to increase the number of places in medical colleges and more doctors in our hospitals and in our GP service overall, which are essential. However, we still need to examine how to reduce the pressure here and now. We must use all our resources to help in that regard. Expanding the role and having a conversation about how to expand the role of community pharmacies is key to that. International evidence shows that minor ailment schemes now being pushed forward by community pharmacists are effective in providing accessible and timely care at the lowest level of complexity, which is the key point. They allow for access to community pharmacy services for all patients and help free up capacity in primary and secondary care for more complex cases.
A recent survey by the Royal College of General Practitioners and the Royal College of Emergency Medicine in the UK estimated that one in every seven GP consultations and one out of every 12 accident and emergency attendees could have been dealt with by a visit to a pharmacist. There is no reason the story would be any different here. Freeing up capacity in primary and secondary care by directing people to a pharmacy first is an important step to delivering on the objectives of Sláintecare. A minor ailment scheme would demonstrate Government commitment to enhancing public health access, delivering quality patient care and improving health outcomes. Pharmacists, medical experts and community pharmacies are already a natural first point of call for minor injuries and advice. As the Minister of State knows, pharmacies are located in towns and villages across the country and many of them offer a seven-day service. They have the experience and commitment to build on our current services. More should be done to help alleviate the pressure on GPs. I look forward to the Minister of State's response.
Mary Butler (Waterford, Fianna Fail)
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I thank Senator Gallagher on behalf of the Minister for Health for raising this important issue. The Minister recognises the significant role community pharmacists play in the delivery of patient care. Community pharmacy is often the most accessible avenue to receiving such care and provides a vital link in our healthcare systems by ensuring the safe supply of medicines to people. We saw that come to the fore during the Covid-19 period when our community pharmacists were the first port of call for many people, as they are on a daily basis. Medicines are the most common healthcare intervention and the use and complexity of medicines are increasing. Pharmacists are the healthcare professionals optimally placed by virtue of their training to ensure the rational and safe use of medicines by patients.The Minister also acknowledges the vital role that community pharmacy will play in the development and implementation of future healthcare reform, especially in regard to the aims and vision of Sláintecare. The focus of Sláintecare is to develop primary and community care and make it possible for people to stay healthy in their homes and communities for as long as possible. The underpinning objective and rationale for enhanced services to be delivered in community pharmacy practice will be to realise enhanced patient care and access. The Department is aware of developments, nationally and internationally, which evidence an evolving and enhanced scope of practice beyond the traditionally perceived pharmacy practice framework. I was struck by what the Senator said, that evidence has supported that one in seven visits to a GP and one in 12 to an emergency department might not be as necessary as is thought, if they had that support.
During the Covid-19 pandemic the HSE established a working group, now called the community pharmacy planning forum, which has examined the challenges confronting community pharmacists during the Covid-19 emergency and played a key role in resolving them to the benefit of the people of Ireland. The impact of its work can be seen in the important role that community pharmacists played in the national Covid-19 vaccination programme - the largest vaccination programme ever undertaken by the State. The forum provides an opportunity for stakeholders, including the Irish Pharmacy Union and the Pharmaceutical Society of Ireland, to provide insights on how community pharmacy can be expanded in the context of healthcare reform. The Department is open to exploring any evidence-based, appropriately governed services, delivered by appropriately trained professionals which will support this aim.
The Department recognises the need for the availability and retention of pharmacists in order that pharmacy may continue to meet patient needs and play a full role in the development of an integrated healthcare system. Many people really trust their pharmacist. Many pharmacists are the regular people who come in to a town, community or village, but are there for many years. Their family is part of the community. The first point of call, for many people, will be the community pharmacist.
Recently, the Minister for Health and Departmental officials met a delegation from the Irish Pharmacy Union and a very fruitful and positive discussion took place. Various proposals regarding extending the scope of practice offered by community pharmacists were discussed. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services and provide better value for money.
Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for her comprehensive response. I am very heartened by it. It would appear that the Department of Health's door is certainly open for discussion as to how best we can utilise our community of pharmacists, with a view to alleviating pressure on our GPs and accident and emergency departments. I am heartened by that. We can take a lead from best international practice, as to the different ailments that could be treated by the community pharmacist. I came across some information recently with regard to prescriptions. Young women aged 17 to 25 years of age had to go to their GP to get a prescription in order to get certain contraceptive pills. The WHO has suggested it can see no reason why they could not go directly to their pharmacist for that service. That is the way it is in the UK, the US, New Zealand, Canada and many other countries. It is the kind of thinking I wish to see incorporated here in order that we could alleviate the pressure on some young woman having to go to a GP, make an appointment, see the GP, get the prescription and then come back to the pharmacist. We are looking for imaginative and creative thinking as to how we can alleviate that pressure. This is just one example.
Mary Butler (Waterford, Fianna Fail)
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The Minister is absolutely committed to the ethos of ensuring that the right care is delivered in the right place at the right time for all citizens. He recognises that all healthcare professionals have a role to play in optimising patient care and service delivery in line with this vision. An example of the importance of the role of community pharmacists can be found in their participation in the free contraception scheme for women aged 17 to 25, which launched in September 2022. The scheme was extended to 26-year-old women from January 2023 and it will be further extended to women aged 27 to 30 in September 2023 of this year. I know everybody welcomes this. The participation of community pharmacists is vital to the ongoing success of the scheme. The Senator is talking about taking it another step further. I am sure everything is on the table.
The focus of current scoping work within the Department is to increase capacity in the healthcare system overall, to deliver better healthcare outcomes and ensure that unintended negative consequences in other parts of the healthcare system do not arise. The Minister believes there is a real opportunity to work collaboratively and with other healthcare providers to make a significant difference to patient outcomes. Obviously, this includes our community pharmacists the length and breadth of the country who do Trojan work on a daily basis. I, as the Senator can hear, have made many calls to the community pharmacist in the past few weeks. Community pharmacists give such care and support. The rule brought in a few years ago, whereby all community pharmacists have a private room where one can go to speak in private if one does not wish to be at the counter, was one of the best moves ever made. Community pharmacists offer such a unique role and support to healthcare services in Ireland.
Martin Conway (Fine Gael)
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It is such an important topic and the Minister of State's reply was outstanding. I think of the great work my local pharmacist, Ciaran Curran, and his team in Ennistymon do, with such professionalism. There is such scope for extending the work they do. I commend Senator Gallagher on a excellent Commencement matter.