ANALYSIS:The depth of anger among pharmacists was evident at a mass meeting yesterday, writes EITHNE DONNELLAN
ON JUNE 18th Minister for Health Mary Harney announced she would be cutting fees paid to pharmacists for dispensing drugs under a range of State schemes, including the medical card scheme, from July 1st in a move aimed at saving €51 million this year and €133 million in a full year.
Pharmacists were told the cuts were provided for under new legislation – the Financial Emergency Measures in the Public Interest Act 2009 – and in effect they could take them or leave them.
As it happens a huge percentage of pharmacists who are contracted to dispense drugs under State schemes – about half of the 1,600 pharmacists contracted to do so if you go by HSE figures but even more if you believe the pharmacists’ union – have decided on the latter option.
They have opted to terminate their contracts with the HSE from August 1st saying the reduction in fees is greater than other health professionals are expected to bear at this difficult time economically and so a great many of their businesses will be rendered unviable.
The depth of anger among pharmacists was clearly evident at a mass meeting held by the Irish Pharmacy Union (IPU) in Dublin yesterday. There was standing room only for some of the more than 1,000 pharmacists who turned up. They made the point again and again that they were willing to share the pain, that they had put forward ideas for alternative savings of €85 million including in the area of greater use of cheaper generic drugs, but that their suggestions were being ignored.
Their vice president Darragh O’Loughlin insisted the cut in income for pharmacists would be 34 per cent, some 10 per cent more than Harney claims it will be. He said this was based on an analysis carried out by Price Waterhouse Coopers for the IPU which found the cuts will actually amount to €84 million this year and €169 million in a full year. He said the analysis had been based on figures provided by the HSE.
Harney’s team claim the cuts will save €133 million in a full year and this figure is accounted for by an 8 per cent reduction in pharmacists’ professional dispensing fees and a clawing back of the value of discounts pharmacists who bulk buy get from wholesalers.
The conflicting figures aside, it’s worth noting if pharmacists have, as Harney suggests, to take a 24 per cent pay cut, it’s more than Ministers themselves have had to bear. Pharmacists don’t entirely depend on their income from State schemes – they also have income from private patients and from non-medicinal products.
In addition the point is often well made that medicines in the Republic cost multiples of what they do in other European countries and that this issue should be tackled to bring down the cost of the State’s community drugs bill which came to over €1.6 billion last year. It’s also pointed out that GPs should prescribe more generic drugs as pharmacists have to dispense whatever is on GP’s prescriptions.
Harney says these issues will also be tackled in time but they need to be addressed urgently as it would be unfair if the pain of bringing down drugs costs here wasn’t shared equally between manufacturers, distributors and pharmacists.
But the more imminent crisis which will result from pharmacists withdrawing from State schemes on August 1st is of most concern now. Their action will cause hardship for patients who will have to travel farther for their medicines and it appears no contingency plan devised by the HSE will be able to fully make up for the loss of their input.
At a time when swine flu is spreading and when the HSE will be expecting pharmacists to play a key role in dispensing antivirals, key figures on both sides should sit down now and talk about finding a compromise.