A consistent failure to invest in pharmacy services will have serious consequences for community healthcare if not urgently addressed, warned the Irish Pharmacy Union (IPU). The Association said that community pharmacies are now at a ‘tipping point’ and require a restoration in fees to protect the viability of many pharmacies around the country and to maintain key services to patients. They called for the Minister for Health to immediately begin substantive talks ahead of a statutory review of pharmacy fees in June.
Since 2009, the amount paid to pharmacies per item dispensed has reduced by 19 per cent, while the costs for dispensing medications on behalf of the State have increased by 23 per cent. This is not sustainable and will soon reach the stage where it will cost more to dispense an item than what is paid by the State. In the same period, the revenue to pharmacies for State schemes has reduced by 29 per cent, while costs have increased dramatically and are continuing to increase. Pharmacies are in fact in certain circumstances subsiding the State for implementing schemes on behalf of patients and this goodwill cannot continue, said the IPU.
Minister for Health Stephen Donnelly TD is obliged, under the Public Service Pay and Pensions Act 2017, to review pharmacy fees before the end of June this year. Community pharmacists are calling for a modest increase in dispensing fees to €6.50 per item, representing an increase of just 50 cent on the rates paid in 2009.
According to Ms Kathy Maher, the Chair of the IPU’s Pharmacy Contractors Committee: “This restoration and recalibration would be fair and just when looking at other sectors, and those working within healthcare. Despite repeated calls for engagement, the Minister for Health, Department of Health and HSE have left us in the dark. We expect and demand, as a matter of basic respect, that the Minister will engage with the sector in the coming weeks.”
Ms Maher said that the lack of adequate funding and treatment of pharmacists has been manifestly unfair, unjust and discriminatory when compared with other professions. “In recent times, we have seen civil servants receive an average of 12 per cent pay increases, other healthcare professionals such dentists, nurses, consultants and even hospital pharmacists receive an average of 14 per cent increase. Since the 2019 GP agreement, the additional annual expenditure provided to GPs has increased by €211 million.”
It should be noted, said Ms Maher, that pharmacy fees were cut under the Financial Emergency Measures in the Public Interest Legislation in 2009. “But the emergency is long over, and we still have not seen any restoration in comparison to other healthcare sectors. Community pharmacists have been roundly ignored, despite assurances and we are now expected to do more work for the State, for less money, while baring higher costs — this is simply unsustainable.”
The convenience and accessibility of the pharmacy network is one of the “shining lights of our health system,” according to Ms Maher. “At the same time as the new HSE boss, Bernard Gloster, is calling on hospitals to function more efficiently at weekends, the continued underfunding of pharmacies will lead to weekend closures and reduced hours, particularly in rural areas. The knock-on problems if people cannot receive their medications on weekends will be immense, with knock-on impacts on the whole healthcare system.
“Pharmacy closures, particularly in rural locations, are becoming increasingly likely. Many pharmacies are fast approaching a tipping point, particularly smaller pharmacies in rural locations that provide an invaluable service to the communities. We must do everything we can to prevent closures which would have an irreversible impact on local areas, particularly those areas that have seen a decline in their GP and other healthcare services.”
Concluding, Ms Maher said: “Minister Stephen Donnelly has a decision to make in the coming weeks. We are at a crossroads and community pharmacists’ patience is running out. He can choose to engage with the pharmacy profession, in a meaningful way, treating Irish pharmacists with the same fairness and equity that other professions receive, or he may choose to look the other way, showing disregard for pharmacy and the public. The decision is his.”
