The Maria Bailey injury claim debacle makes Fintan Moore reflect on Ireland’s claims culture and its relevance for pharmacists 

There’s been a lot of public anger directed at TD Maria Bailey for her abortive attempt to sue the Dean Hotel for damages due to her now infamous fall from a swing in the hotel. The reason for the level of disquiet is pretty neatly summed-up by Michael McDowell’s caustic observation in the Seanad, where he said “if the Government is serious about driving down the claims culture, we cannot stand idly by when adults lose their seat with two objects, one in each hand, and fall off a swing and then claim that there should have been a supervisor looking after them”.  The fact that the ‘boldest swinger in town’ was being represented by the family law firm of Culture Minister Josepha Madigan served to further add insult to injury for people following the case. I hasten to add that Minister Madigan has clearly done nothing wrong, and people are perfectly entitled to seek legal representation with whomever they wish. However, the optics are not good, and it’s reckoned by many Fine Gael members that hundreds of votes were lost per constituency as a result of this case.

The opprobrium thrown Bailey’s way reached such a level that some commentators felt it was over the top, but personally I have to say that my sympathy is limited to the point of being non-existent. This debacle may cost Bailey her seat at the next election, but the popping of her privilege bubble counts for nothing in my book when set against the real jobs being lost by real people in the real world because insurance costs have been allowed to spiral out of control. A major driver of costs has been the number and size of legal claims for damages. There are play groups, voluntary bodies and activity centres that have shut down. Businesses and schools are often over a barrel being shaken down for higher premiums. This problem has festered for years while the Government has made vague sympathetic noises with no real action, so the sight of Bailey playing the system raises the obvious question of whether they ever actually gave a damn, or if they were happy enough that the status quo was making profits for the ‘right’ people. I’ve consistently voted for Fine Gael over the years, but that vote is now swinging — I just won’t whine when I pick a direction to fall.

A major driver of costs has been the number and size of legal claims for damages. There are play groups, voluntary bodies and activity centres that have shut down. Businesses and schools are often over a barrel being shaken down for higher premiums

The relevance of this to pharmacy is best explained by referring to the term used to describe us by the PSI — ‘Retail Pharmacy Business’. The public come into our shops — we all have floors they can slip on, shelves they can walk into, doors they can catch their fingers on, footpaths they can trip on, car parks they can fall in, etc. We are squarely in the crosshairs for the claims culture vultures. We are not alone — the MD of Supermacs recently complained of being targeted by scam merchants. So there is an obvious course of action to be taken here, which is to form an umbrella alliance of all businesses that deal with the public — retailers, pubs, hairdressers, bookies, cafes, restaurants, etc, and make a list for all politicians of demands regarding insurance and legal claims. Instead of calling for ‘something’ to be done, the alliance can get legal advice of its own, and make a Ladybird guide of specific changes that it wants enacted into law, with constitutional amendments to be voted on if necessary. Included in the changes can be reform of the current defamation laws, under which retailers can be sued for tens of thousands of euro for wrongful accusations of shoplifting. 

Large sums can be awarded even where the item suspected of being stolen had a trivial value, and the retail staff handled the incident discreetly and professionally. Any political party or independent that supports the list can be in turn supported by members of the alliance. Given the likely Dáil arithmetic after the next election, a small political party or a few independents could be enough to get this over the line.

Sore Spot

Cold sores present an occasional problem for a large percentage of the population, but some people are afflicted several times a year. The sores are unsightly and painful, and the virus poses a risk to very young infants and to the immune-compromised. Given the rate at which over-the-counter Aciclovir creams sell, it is surprising that there are so few prescriptions dispensed for antiviral tablets. There was a time that such tablets cost a small ransom, but those days are long gone, so price should no longer be a factor for private patients. Obviously, for GMS patients the cost was never a barrier, other than any budgetary impact. A useful and relatively inexpensive option for treatment is to use two doses of 2,000mg Valaciclovir 12 hours apart, taking the first dose at the first ‘tingle’. Keeping a course of tablets handy in the medicines cupboard avoids any delay in treatment. For people who complain of recurrent sores, I have suggested that they discuss this course of action with their GP, and the reaction has been positive.

Soft Heart, Hard Head

There was a time in pharmacy that the adage ‘Look after the patient and the money will look after itself’ was the most important advice to follow. It still holds true to a large extent, but you need to really keep your wits about you these days. It’s okay to be empathetic with patients and to do your best to help them, but it’s important not to become a soft touch. The reality in pharmacy these days is that unlike 10 or 15 years ago, there are now no ‘really valuable patients’, so there is a limit to how much financial risk you should take to help somebody. A case in point was raised on an Internet chat forum recently, where a pharmacist said she had been asked to supply a course of six months of a CF treatment that had a cost of €3,000 per month, and that the drug needed special approval from the HSE. She correctly pointed out that assuming she actually got paid, her reward for dispensing €18,000 of medication would be €21 before associated costs. She had worked out herself that this was not a reasonable request, and she was perfectly right about that, but was just checking for alternative viewpoints — understandably, there were no dissenters. If hospitals want to save money on their drug budgets, that’s all well and good, but it shouldn’t happen at our expense.λ