Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 569 and 683 together.

Under the Financial Emergency Measures in the Public Interest (FEMPI) legislation, payments to pharmacy contractors were restructured in 2009, 2011 and 2013, under:

• S.I. No. 246/2009 - Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2009.
• S.I. No. 300/2011 - Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2011.
• S.I. No. 279/2013 - Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2013.

Among other things, dispensing fees moved from a mixture of professional fees and retail mark-ups to an increased standard fee which was reduced on a sliding scale based on the number of items dispensed in a month, as follows:

• €5.00 for the first 1,667 items each month,
• €4.50 for the next 833 items, and,
• €3.50 for any remaining items.

The regulations governing the pharmacy fee structure that were made under section 9 of the FEMPI Act 2009 expired at the end of 2019. Under the Public Service Pay and Pensions Act 2017, these regulations had to be replaced by 1 January 2020 in order to maintain a statutory basis for contractor payments and to prescribe the fees payable from that date.

The current pharmacy fee structure was put in place by the Public Service Pay and Pensions Act 2017 (Payments to Community Pharmacy Contractors) Regulations 2019 – S.I. 639 of 2019 – which came into effect from 1 January 2020.

Since then, the overall spend on fees paid to community pharmacists under the community drug schemes has continued to rise year-on-year. The Primary Care Reimbursement Service (PCRS) online system shows fees paid to pharmacies under the community drug schemes in 2019 of €420.9 million, rising to €468 million in 2022. The State has also paid for additional services provided by community pharmacists. For example, in 2022:

• €22.51 million in respect of COVID-19 vaccination fees were paid to pharmacists. Broken down this was €16.47 million in respect of vaccination fees, plus €6.04 million in administration fees.
• €7.55 million was paid to community pharmacists for administering flu vaccinations.
• €4.32 million was paid to community pharmacists for participating in the contraception scheme which launched in September 2022.

The State paid just over €502m in fees to community pharmacists in 2022. This demonstrates the substantial investment made by the Government to keep pace with the increased activity across the community drug schemes and to ensure that community pharmacies are remunerated for the services they provide on behalf of the State.

Under Section 42(14) of the Public Service Pay and Pensions Act 2017 the pharmacy fee structure must be reviewed every third year after 2020. My Department is currently carrying out a review and Department officials have arranged to meet with the Irish Pharmacy Union in that regard.

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.