A HIGHLY vulnerable group of customers has been targeted by the Irish Pharmaceutical Union (IPU) in its dispute with the Government over drug margins and dispensing charges. On the last occasion the government tried – and failed – to cut their profit mark-ups, some IPU members threatened to withdraw methadone-dispensing services from heroin addicts. This time, medical cardholders have been placed in the firing line. Such bullyboy tactics should not be tolerated.
If we are to get through this economic crisis as a cohesive society, all groups must be seen to pull their weight and take their share of pain. For many years, a succession of reports urged reform of the pharmaceutical sector because of a lack of competition and the high cost of prescription medicines.
Much of this has been the fault of successive governments. Not only does the government set the “trade price” for prescription medicines at plant level, it negotiates the wholesalers’ distribution margin, along with the drugs mark-up and dispensing fee system for pharmacists. In fact, the State pays 80 per cent of the value of all prescription drugs. And the taxpayer has been ripped off for years.
Cutting costs in the pharmaceutical sector is just part of a larger health reform picture. Minister for Health Mary Harney has indicated that the so-called An Bord Snip Nua will make recommendations for a €1 billion cut in health spending in its report expected to go to Government this week. And she said that pharmacies, where fees had doubled during the past seven years, could not be exempt.
We have been here before. On the last occasion, in 1986/87, savage cuts in health services and other spending took place as the then Fianna Fáil government attempted to prevent a slide into bankruptcy. The first social partnership deal involving employers and unions had just been agreed. Alan Dukes, on behalf of Fine Gael, provided further stability with the Tallaght Strategy.
Reform within the health services on that occasion took second place to immediate cost-cutting. So many hospital beds were taken out of the system that the effects were being felt 20 years later. Nurses were let go. But poor management structures, high remuneration rates and inefficient working practices remained. That must not happen again.
There is no denying a need to reduce costs. But patients should not have to bear the full brunt of that exercise. They, after all, are the ones who fund the system. For too long, services have been configured to suit the service provider, rather than the service user.
Closing beds and cutting services are the easy options. Reducing remuneration levels and altering work practices are more difficult.
Already, the centralisation of accident and emergency services and the closure of beds in some areas have given rise to complaints. Promised facilities and procedures and new home-based services have not been put in place. Meanwhile, a bloated Health Service Executive, containing a surplus of overpaid staff members, remains unreformed.