Comment: Those of us who keep an eye on such things remember the launch of the Government's Health Strategy. It was election year 2002 and the build-up was mighty. For months beforehand consultations were conducted by the Department of Health with thousands of healthcare workers, writes Liz McManus.
The big day dawned and the Mansion House buzzed with crowds of people, droves of PR handlers, and the glittering presence of the boyish Minister for Health promising us the sun, moon and stars. In case we missed the point each TD was presented with a copy of the glossy report.
So it is odd that we have yet to receive a copy of the latest report to be published by the Minister for Health. In fact the deafening silence surrounding the publication of the Report of the Pharmacy Review Group, now known as the Mortell report, is in stark contrast to the glitz of the Health Strategy launch.
This latest report appeared without a whimper - let alone a bang - from the Minister. Uncharacteristically he said nothing at all.
The report was slipped out late last Friday afternoon when the rest of us were packing up to go home for the weekend and without even a Departmental press release to take the bare look off it.
Abandoned at birth the Mortell report was smuggled onto the Department's website without Ministerial comment and clearly in the hope that as few people as possible would notice.
The pharmacists noticed and they were less than pleased. One can see why. They have been waiting a long time for this report.
The Department of Health received it more than 12 months ago in January 2003, sufficient time, one would think, to formulate a response to it. Yet with its publication we are still no wiser as to what the Department and its Minister intends to do with its recommendations.
In reply to a parliamentary question answered this Wednesday the Minister was tight-lipped. All he would say was that he was still examining the "legal and other issues surrounding the group's recommendations".
He declined to comment on the grounds that it would not be appropriate for him to comment on the report's recommendations before completion of this examination.
The Irish Pharmaceutical Union has initiated a strong offensive against the report and its findings. Its president, Mr Richard Collis, said the future of independent pharmacists was under threat. He and his union have been fighting to regain ground that has been lost to them.
In 1996 the IPU and the Department of Health made an agreement that regulated the community pharmacy sector and included tight restrictions on the granting of pharmacy contracts on a geographic basis. The celebrated case of Knock being denied a pharmacy was one effect of the rigidity of these regulations .
In 2001 the OECD published a report called Regulatory Reform in Ireland. It found: "Pharmacies are highly regulated in Ireland to ensure safety and availability of services to rural areas, but more sensible regulation could bring down prices without endangering safety or accessibility.
"The restriction on economic freedom of pharmacists educated in other EU countries should be eliminated, as should restriction on the location and number of pharmacies."
On January 31st, 2002 continuing legal challenges led the Minister for Health to revoke the 1996 regulations without warning.
What concerns the IPU most is the possible acquisition of community pharmacies by large multiples.
"The main beneficiaries of Ireland's deregulated market include international companies and large retailers who are prevented from buying retail pharmacies in most of the major European markets because of regulation in those countries," says Mr Collis.
According to the Mortell report, while there is already greater penetration of the market by both Irish and non-Irish chains "No chain is large enough to be a dominant force (the largest currently has about 5 per cent of the market in terms of outlets) although there is concern that a chain with enough outlets in a given area might be immune from competitive concerns and use its market power to lower service quality, opening hours etcetera."
It is only one of a number of issues to be addressed.
The price of drugs in Ireland is another but, overall, we should remember that pharmacies are not like grocery shops.
They are an important part of the delivery of primary healthcare. Pharmacists, along with general practitioners, district nurses and community health workers play a vital role in meeting the health needs of the public.
As one family doctor told me this is even acknowledged in legal practice where if a case is taken to court on an issue of a drug prescription the pharmacist is held to be 35 per cent liable.
We are fortunate that we have in Ireland a highly professional pharmacy sector, respected by the public and trusted within the health service. The tight regulation of the past cannot and should not be re-instituted but it is important that reasonable controls are put in place to ensure standards and access for the future.
This Government tends to be driven by free-market ideologues within it.
There is a real danger that harm could be done for ideological reasons that are unconnected with - and even inimical to - the needs of patients. So far we don't know what the Government intentions are because the Minister for Health isn't telling.
Currently the Republic has the least regulated pharmacy market in all of the EU and after the long wait for the publication of the Mortell report we are still no wiser as to how, or when, the Government will address the issues it raises.
It affects their livelihoods and more importantly may well affect the way that patients access community pharmacies .
The author is deputy leader of the Labour Party and spokesperson on health
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