HSE to face public watchdog over dispensing fees dispute

The HSE is to be called before a Dáil watchdog to explain how pharmacies are able to claim multiple payments worth millions of euro for single prescriptions presented by medical card holders.

The public accounts committee (PAC) will investigate revelations that Lloyds, the largest pharmacy chain the State, claimed up to four fees in a month in respect of a single prescription dispensed in one visit, its chairman, Fianna Fáil TD John McGuinness, said.

Mr McGuinness said the committee would seek an explanation from the HSE as to how this happened and over what period of time it had occurred.

“They will also have to present us with plans to ensure this doesn’t happen again.”

HSE bosses were already due to appear before the committee early next month, and Mr McGuinness said they would also be asked to explain the “squandering” of public money involved in the payment of dispensing fees.

“This is yet another example of appalling management in the HSE and it’s about time the Minister for Health intervened to ensure someone is held to account this time,” he said.

Committee member and Fine Gael TD Patrick O’Donovan described media reports of the payments by the HSE to Lloyds as very concerning and said they posed many questions about the way the HSE operates its prescription payment methods.

Lloyds has denied any wrongdoing in its claiming of phased fees in respect of a single prescription dispensed in one visit and has insisted its approach is no different from other pharmacy chains.

The HSE is now expected to examine whether or not any other pharmacy chains are claiming phased dispensing fees in respect of large numbers of payments.

Lloyds operates a system known as MyMed, which, in the case of a four-week drug supply, involves putting a patient’s medication into four separate compartmentalised trays, one for each seven-day period.

The drugs are all supplied to a patient in a single visit to the pharmacy.

Dispensing fees

Lloyds claims it is entitled in such a case to both the first dispensation fee of €5 and three additional phased dispensing fees of €3.27 each.

The HSE, however, contends that when all medication is dispensed to a patient on the same date, Lloyds is entitled only to the €5 dispensing fee per prescription item.

Internal promotional material seen by The Irish Times shows that branch managers were encouraged to promote MyMed among patients, with a resulting 66 per cent increase in dispensing fees.

Darragh O'Loughlin, secretary general of the Irish Pharmacy Union – which does not count Lloyds among its members – said phased dispensing of this type was appropriate for a small minority of vulnerable patients.

Organising a patient’s medication in this way involved considerable work and time on the part of a pharmacist, who could not be expected not to be remunerated for this.

However, it was never intended that phased dispensing would serve as a mechanism for improving fee income, he added.

This article was amended on August 31, 2015