A RETURN to normal pharmaceutical services is welcome. Some persons with medical cards – the elderly and heroin addicts on methadone treatment – were particularly distressed by a withdrawal of dispensing facilities. These vulnerable individuals were used by the Irish Pharmacy Union (IPU) in a crude attempt to block a reduction in dispensing fees provided for by emergency legislation aimed at reducing public spending. Patient care failed to receive proper attention in a dispute that centred largely on money and the defence of privilege.
IPU president Liz Hoctor has insisted the dispute is not over though she called on members to resume normal services and said the IPU would write to Minister for Health Mary Harney and set out proposals on how the future relationship between the parties should be conducted. It sounded like tough talking. But the message attempted to disguise a comprehensive defeat. What had once been a powerful vested interest group had fragmented in the face of the Government’s determination to curtail its costs and their profit margin.
A considerable amount of reform has taken place within the sector in recent years. Foreign and domestic companies invested heavily in establishing group pharmacies. Barriers to employment and new businesses were swept away. The outcome, compounded by booming property prices, was a greatly enlarged and heavily indebted sector. Two years ago, the IPU prevented the Minister for Health from cutting dispensing fees by launching a successful court action. But it was only a matter of time – and the passage of new legislation – before battle was rejoined. This time, the groundwork was properly laid and Ms Harney made no mistakes. Divisions between pharmacists were exploited; the Health Service Executive put special dispensing arrangements in place and fewer than half of all chemists joined in the dispute. The Minister for Health has done well to hold her nerve and to protect the public interest. While she and her department can be blamed for allowing costs to run out of control in the first place, the example set in this confrontation should encourage her Cabinet colleagues to push ahead with other necessary reforms. During the years of rapid economic growth, professional groups, public servants and those who shouted loudest tended to receive the most munificent consideration. Now, with the public finances in crisis, they should bear a fair share of the necessary restructuring. There is a considerable way to go.