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An open letter to Minister for Health Simon Harris

By Ultan Molloy - 03rd Dec 2019

December 2019

Dear Minister Harris,

I am writing to you in relation to the proposed additional cuts in payments to pharmacies under FEMPI legislation enacted in 2009.  

Pharmacists have had cuts in excess of 37 per cent from State schemes since 2009 (c.€1.54 billion), and 10 years on, we are no closer to having the cuts imposed under FEMPI reversed.  Indeed, we are no closer to having a fit-for-purpose pharmacy contract.  Why, when our GP colleagues in primary care are no longer under this cosh, are you are considering imposing further unreasonable cuts in payments, which you are not obliged to make under the ‘law of the land’, or any other law?  

We are no closer to having extensive extended services through an efficient and effective primary care network of nearly 2,000 accessible healthcare professionals in pharmacies distributed countrywide, that have over 78 million visits annually from many sick and vulnerable people.  With 81 per cent of the Irish population visiting pharmacies at least once per month, and a 98 per cent satisfaction rate, why are we not having the promise of this network fully realised for public health and patient care? For the last 10 years, pharmacists have been courted by successive governments and ministers such as yourself, Minister Harris. You can be the difference.

To quote yourself, Minister, pharmacists do indeed have the “ideas”.  Pharmacists not only have ideas, but they also have demonstrated a healthy appetite to extend services. They can do this safely and effectively in Ireland, as you have seen by the impact of pharmacist involvement in the nationwide primary care flu vaccination service, the minor ailment scheme trials, the access to emergency contraception, and other initiatives. Uptake of the flu vaccination has increased hugely in vulnerable patient populations, without any downside, and it has likely saved hundreds of lives in that time. “Ideas” such as a minor ailments scheme, a new medicines scheme, prescribing for chronic ailments, contraception services and extended vaccination are already in place and saving thousands lives and billions of public monies in other countries. So, what are you waiting for?  

You have an opportunity here, Minister Harris. You have an opportunity to act. You have an opportunity to show that you can demonstrate a vision for patient care in primary care. You have an opportunity to look at best practice in New Zealand, Scotland, Canada and elsewhere, and save lives and the public purse by maximising the use of the robust resource waiting to be tapped, that is the pharmacy network. You have an opportunity to collaborate with pharmacy contractors this January 2020 without imposing further unfair and unjust cuts on an already stressed pharmacy and primary care sector. You can develop a patient-centred, outcome-orientated pharmacy contract on a foundation of goodwill, as has already been shown by pharmacists tolerating the ever-increasing non-contract administrative burden over the last number of years. So, what are you waiting for?  

Pharmacists are leaving the profession by the day, with increasing pressure already posed by cuts and a sense of frustration at not being able to put our best foot forward after five years of training for the people we see coming through the door. Pharmacy owners are starting to throw in the towel, as the pharmacist shortage is moving to a tipping point, where closing the door and working for someone else will be more inviting that opening the doors for your community and locality every morning.

Minister, I am asking you not to impose further cuts, which in our pharmacy’s specific case in Ballindine, and we are a lower than average turnover for the sector, will mean over €60,000 off our bottom line. That’s two or more tax-paying jobs among the 27,000 employed in the sector, that contributes over €2 billion annually to Ireland’s GDP. Incidentally, we have recently taken on two great people in order to cover statutory and sick leave and resource our administrative team. This supports the pharmacists so we can spend more time with patients and customers in our consultation room, at the counter, and on the phone. This time is where patients and customers get the real value from their pharmacist.  It is where the most vulnerable communication happens, and where trust and transparency is built. It is where potentially life-threatening issues are picked up and dealt with professionally.  It is where potential errors are unearthed. It is where clarification is achieved, misunderstandings addressed, and when patients get their medicines safely and effectively. Pharmacists are not merely a conduit for drug delivery, sticking labels on boxes, and smiling politely. Much like the proverbial duck, the frantically paddling under the water line into a torrential upstream current is progressively leading to burnout and withdrawal, and it is the Irish public who are suffering.

Please consider those patients who are the recipients of the 80 per cent of medicines we dispense under the State schemes.  They are not like you or me in terms of age, health or income. They are, however, the silent majority.  They are the ones who get the most benefit from our professional services, and yet they are under your radar day-to-day. They are often elderly, chronically ill, mentally ill, and needing professional support in a walk-in capacity, and we greet them with a smile, empathy, kindness and professionalism. They are not making policy and having meetings, as you are on their behalf. You can be the difference in the lives of this generation and future generations of Irish people. So, what are you waiting for?  

Wishing you and yours a happy and healthy Christmas and year ahead. Let’s all make it a better one for everyone. 

Kind regards,

Ultan Molloy, MPSI ACC

BPharm (Hons), MSc (Biopharmacy), MBS, MA, IoD Dip Company Direction. 
HealthWest Community Pharmacy
Ballindine
Claremorris
Co Mayo

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