Fergus O'Dowd (Louth, Fine Gael)
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122. To ask the Minister for Health his views on matters raised in correspondence (details supplied); and if he will make a statement on the matter. [55715/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I recognise the significant role that community pharmacists play in the delivery of patient care. Indeed, community pharmacists have played a central role in the national COVID-19 vaccination rollout – the largest ever undertaken by the State. I also acknowledge 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.

During the COVID-19 pandemic the Health Service Executive (HSE) established a Community Pharmacy Contingency Planning working group with relevant stakeholders, including the Irish Pharmaceutical Union (IPU) and the Pharmaceutical Society of Ireland (PSI), to support the implementation of all COVID-19 support measures. This group – now called the Community Pharmacy Planning Forum – had examined the operational and clinical 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 work of the Forum has now transitioned to discussing the strategic direction of the community pharmacy profession. This will prove invaluable in the context of future contractual reform. 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.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the Community Drug Schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. In the case of reimbursement to pharmacy contractors, it is important to note that under Statutory Instrument No. 279 of 2013, the "ingredient cost" of a reimbursable product is defined as:

"(a) in the case of fridge items, the ex-factory price together with a wholesale mark-up of 12 per cent, and

(b) in the case of any other drug item, the ex-factory price together with a wholesale mark-up of 8 per cent;"

Therefore, when reimbursing community pharmacists, the HSE generally applies a factor of 8% to the ex-factory price as per the definition of ingredient cost. At the time, it was considered that the settlement terms and discounts between a pharmacy and their mainline wholesaler supplier were such that the net price a pharmacy was actually paying would be covered by the HSE reimbursement price. However, it is understood that some wholesalers continue to invoice at the traditional markup, rather than the reduced price, and this may enable the perception that the HSE reimbursement price is not covering the ingredient cost. In circumstances where an independent pharmacy believes that a wholesaler who also operates as a pharmacy is exercising an unfair competitive advantage, they may raise the specific issue with the PSI as the pharmacy regulator, and with the Competition and Consumer Protection Commission, as the Competition regulator.

I also understand that there are reports of a current acute workforce issue, particularly in relation to community pharmacy. The PSI has been liaising with stakeholders, including the IPU, on efforts being taken within the sector to understand and address the issue. This a complex problem with many contributing factors and multiple stakeholders. Workforce challenges are being experienced in other sectors nationally, and in the pharmacy sector in a range of other countries.  This re-enforces the need for robust data for Ireland to be best able to determine the current landscape, assess future health system needs and understand existing sectoral challenges now and into the future.

The PSI are currently undertaking a project, titled ‘Emerging Risks to the Future Pharmacy Workforce’, which is set to “assess emerging risks to the continued availability of a professional pharmacy workforce within community and hospital pharmacy in Ireland”. As part of this project, the PSI have committed to share any relevant data emerging with relevant Government departments particularly if trends are identified that indicate a future deficit. It will be on the basis of gathering and analysing up-to-date, robust and relevant data, that recommendations can be proposed to address Ireland’s needs for a pharmacist workforce in the future, as Ireland’s healthcare system evolves, and in the context of Sláintecare implementation. I will engage as necessary with government colleagues in addressing relevant issues as they arise.