Ultan Molloy tries his best to be positive about the end of lockdowns and the pharmacy sector
I feel like my brain has been in a holding pattern for the last month. Answers to questions like ‘any craic?’ or ‘what did you get up to on the weekend?’ are always delivered with irony. A Zoom call with friends one Saturday evening only served to compound my present sense of inertia. The realisation of mass vaccination, and of trips away, away anywhere other than the pharmacy and the supermarket, seem to be close enough to touch. I can’t let myself dream too vividly.
The heartache of those dreams not becoming a reality in the near future would be all too much. I will be getting my passport renewed though, given it expires in June. Just in case. I was in Galway today for some essential shopping and it is apparent that the lockdown has come to an end for many. I spoke to a friend on the aforementioned Zoom call who said that Dublin is very much in lockdown in his locality, and being monitored closely by the local gardaí. He’s at the end of his tether with a small child in the middle of Dublin, expensive childcare, and endless Zoom meetings for his work.
What else is going on, past more of the same?
I was reflecting on a financial planning article from 2016 that I wrote here in Irish Pharmacist, and we’re nearly five years on from its publication. I’ll have to dig it out. I wasn’t as bullish as hindsight suggests I should have been when it comes to the stockmarket, if it was mentioned at all. I’ve cashed-out much of our meagre company funds invested in stocks to afford us some cash flow for our new business, as the market appears to be somewhat overheated. Time will tell if this is a sensible course of action, or complete folly, given deposit account rates of interest are below the present rate of inflation. ‘If you’re not in, you can’t win’, and all that.
Not being particularly optimistic, or bullish, about the community pharmacy sector as an investment remains a theme in my life, and much of my writing also perhaps. We do have a lot to be thankful for over the recent short term, however. We have not been closed down, as we’re an essential service, allowing us to care for our communities and keep our friends and colleagues employed.
We have seen advances in the use of technology, such as Healthmail, which overall has been a good thing, albeit in its infancy (I hope!), given it could be so much better and needs to be customer-led, having had some issues with surgeries directing patients to preferred pharmacies. Preferred by the surgery, like, or at least the prescriber, and not necessarily the patients. There I go again with the flip-side of a positive outlook. You can’t say I didn’t try.
Perhaps Amazon, or a version of it, will shake up the Irish pharmacy market in time. As things stand, the primary operating model appears to continue to be as boringly traditional as it has been for the last couple of decades, albeit significantly less profitable. Prescription item volumes increasing, and an ageing population, will present opportunities, no doubt. We have, however, in excess of 80 per cent of those items dispensed
under Government schemes, and little opportunity to develop our non-Government associated remuneration possibilities.
It’s been all about the GPs really, after token discussions around parity and professional engagement around community pharmacist involvement in the Covid vaccination roll-out. Ten years on, the minor ailment scheme, new medicines scheme, chronic illness management in pharmacies, etc, all seem to be no closer, so that’s just the way it is going to be. For now, anyway.
A friend of mine shared the concept of having ‘high agency’ with me this week. Google says: “High agency is a sense that the story given to you by other people about what you can/cannot do is just that — a story. And that you have control over the story. A high agency person looks to bend reality to their will. They either find a way, or they make a way.” I love it. I’ve come across these kinds of people over the years, and while I’m perhaps of moderate agency at present, I found the whole concept liberating and encouraging. High agency can be developed. We can develop it, and we can develop greater agency.
There are ways to make things happen, and it can be helped significantly by one’s mindset and attitude, along with relationship skills and a healthy win-win strategy. Thank you, Mr Covey, and your seven habits. Victim or victor, and all that too!
So, anyway, have a good month ahead. Hopefully we’ll have half the country vaccinated by the time you’re reading this, and the civil servants who just can’t be bothered to consider a better way of using the Irish pharmacy network to deliver to its full potential for the Irish public will have been promoted to their level of respective incompetence. At least away from anything to do with the community pharmacy budget. Or is that the ‘drugs budget’? Maybe considering it as a professional healthcare network supported by dispensing fee payments is a good place to start. Then maybe follow on in discussions like the GPs, with ‘resource us appropriately to do our job, or patients will die’.
Community pharmacists won’t have enough time to give to patients in the consultation room in order to support their self-care adequately, and prevent those up to 25 per cent of medicines-related hospital admissions. We still have FEMPI in place. Meanwhile, the fee payments to GPs have increased by 30 per cent between 2014 and 2019 (€453 million to €589 million), and we will now no doubt see another large jump following tens of thousands of €30 phone calls on top of this, given the present crisis. Most GPs are doing a fantastic job I suspect, but it surely doesn’t have to be either GPs, or else pharmacists, who get appropriately remunerated, does it?
Sure, it will all be grand I’m sure. Our ape-like ancestors appeared on the planet about seven million years ago, and we started using tools about 2.5 million years ago. No doubt it will all work out, developing further our ‘high agency’ skillset, at least for another while anyway.