OPINION:The dispute between chemists and the Health Service Executive is about contracts being honoured, not torn up unilaterally, writes Michael Guckian
PHARMACISTS WERE never under any illusions that the campaign we've mounted against the Health Service Executive (HSE) in recent months would be popular or easily understood by media commentators.
The easy characterisation of the profession as prosperous was too strong and their understanding of how pharmacy actually works too weak to compete with the HSE soundbites that pharmacists were to blame for the high price of medicines in Ireland.
Of course such soundbites ignore the more complicated reality - like the fact that 76 per cent of the drugs which are dispensed under the Community Drugs Schemes are sold by pharmacists at the very same price as they pay for them; or the fact that patients can buy medicines in other European countries for lower prices than pharmacists can buy them in Ireland; or that the price of drugs in Ireland is set not by pharmacists but by the pharmaceutical industry in Ireland and the HSE itself.
But to pharmacists the issues at the heart of this dispute are so important they cannot be ignored. These issues are the right to representation and the right to fair play. It is about the right to expect your contracts to be honoured and that changes would only come about through negotiation and agreement.
These rights are universally acknowledged - including in the European Charter of Fundamental Rights. But the HSE has decided they should no longer apply in this country.
The profession of pharmacy in Ireland is made up of small entrepreneurial businessmen and women. When the media talk of pharmacists, they talk of the handful of men and women who developed successful and valuable chains - and sold them for significant sums of money. But these chains represent only a small proportion of the pharmacy sector.
To suggest that their fortunes reflect what's happening across the industry is like judging the property market by reference to the value of houses on Ailesbury Road.
This week I spoke to over 1,000 of my colleagues who gathered to stand up for our rights at an emergency meeting in Dublin.
Attendees represented a cross-section of the profession; young people who have taken on huge business loans on the basis of a contract with the HSE which that body has now discarded without warning; second- and third-generation pharmacists now facing the prospects of closing businesses that have been integral parts of their communities for generations; and retired pharmacists who are simply stunned at the aggressive attitude that the HSE has displayed towards their profession.
I made clear to the meeting that pharmacists accepted that changes to our existing contracts (including payment structures) are inevitable.
What I cannot accept, however, is how the HSE or the Government can defend the forced, immediate introduction of a change which will reduce pharmacy incomes by as much as 30 per cent and threaten the forced closure of hundreds of businesses with the loss of thousands of jobs.
Imagine the outcry if any other sector of the economy was to be told that their incomes were to be cut by 30 per cent by diktat within the next four weeks.
Imagine the outrage in this era of partnership if the Government refused to discuss these changes or to negotiate with the representative body of the affected sector on the changes it desired.
Imagine the uproar if, in making this decision, the Government ignored the views of the advisers, which it had commissioned, who said;
(1) international comparisons on the prices of medicines are not reliable;
(2) stakeholders including pharmacists should be consulted on any changes; and
(3) sudden changes should be avoided because of the consequences they could have on the sector.
All of this has happened in our dispute with the HSE.
A recent Irish Times editorial cited last year's dispute over services for methadone patients and said that "members of the Irish Pharmaceutical Union play rough".
But I would ask people to remember that my members initiated the Methadone Treatment Scheme and supported it when the HSE, politicians and local communities turned their backs on it. They did so at great personal and business risk while others engaged in hypocrisy.
Likewise, some will characterise the temporary closure of pharmacies that happened this week as another sign of "rough play". But they will ignore that every pharmacist who attended that meeting to my knowledge, made alternative plans to ensure that his/her patients could get access to medicines and many worked late into the night on returning to their pharmacies to clear backlogs and deal with patients.
It's easy to write about a profession playing it rough. I'd ask people to consider for a moment how a situation could be so mishandled by the Government and by the HSE that they have succeeded in driving this conservative profession to the current breaking point.
Michael Guckian is president of the Irish Pharmacy Union