In our ‘negotiations’ with Government, it’s not pharmacists who hold all the cards, writes Ultan Molloy
I’ve been unsure what to write about in this month’s piece, given that I’d planned to stop writing altogether at the turn of the year, and have been asked back a couple of times. There are a lot of moving parts personally as well as in terms of pharmacy in the last month, and again I don’t know how much value I can add, past sharing a perspective based on my own reflections and observations, so here goes.
The HRT piece I wrote last month didn’t age particularly well, as I pointed out to my Editor. A €1,000 pittance to take part in a Government scheme has now been changed to a €2,000 pittance, and our union has bizarrely now advised us to take it. Nothing else has changed however from the looks of it,
other than a commitment to talks and a framework, which has to happen anyway. We have no other guarantees or assurances going into a ‘negotiation’ process where one side holds all the cards, and it’s not us community pharmacists.
We were in a position of power and solidarity, where less than 100 pharmacies had signed up for a poorly thought-through HRT scheme, with no IT or administrative infrastructure in place, and it not being part of an “overall women’s health plan” that we have been told was needed by our union for months and months now. We capitulated two weeks out from a deadline, without an element of brinkmanship or pressure on a Minister who had a lot to lose, for a once-off change from €1,000 to €2,000.
We didn’t potentially ‘lose’ €50 million either from the sector. We are agreeing now to administer a scheme for a paltry €1.50 per item more (€5 rather than €3.50 on our GMS scripts), which remains €1.50 short of the €6.50 dispense fee we have been repeatedly advised we should be getting to break even, and secure the future of the pharmacy sector.
We also lose our private fee/mark- up on private and sub-threshold DPS, it being replaced by €5 per item under this scheme. So as things stand, and given we’re €1.50 per item less than what the IPU advised was break- even, we will likely have a lot less fee income from our present situation (if our private HRT scripts represent any more than about 20 per cent of our HRT scripts), while accepting a presently unknown administrative burden. Ridiculous. Anchoring bias is a cognitive bias that causes us to rely heavily on the first piece of information we are given about a topic. When we are setting plans or making estimates about something, we interpret newer information from the reference point of our anchor, instead of seeing it objectively. We are now going into a ‘negotiation’ process with a €5 fee anchored as what is acceptable, rather than €6.50, which incidentally we achieved for our professional expertise and administration for the free contraception scheme. It’s backwards we are going.
I don’t buy a “we didn’t have a choice” argument either. We did have a choice. We would continue to have our GMS and private/sub-threshold DPS fees coming into our businesses. This proposed ‘win’, achieving a €5 fee to administer another Government scheme, that isn’t part of an overall women’s health plan, and doesn’t resource the sector into the future, isn’t a win at all. A Minister having to explain to the public why they’re not getting their promised free HRT on 1 June would have been a win. We would be negotiating in a new framework from a position of strength, having indicated that we will not be bullied.
We have been bullied, and clearly continue to be bullied. There is always a choice to do nothing, and betting on
We also lose our private fee/mark- up on private and sub-threshold DPS
the Government and HSE to change their behaviour to something different than how we have been treated for the last 20 years because we capitulated in exchange for a ‘negotiation’ framework with a bully, as a strategy, is akin to Stockholm syndrome.
Bullying by people in positions of power is all the rage now, sure. From politics in the US, to the Ukraine and the situation in Gaza, we really have moved into an unpalatable global paradigm. It seems to be lauded in some quarters as something to be admired. Showing ‘strength’ over collaboration and mutual respect.
At a time of abundance for many, there seems to be a fundamental lack of empathy and appreciation of our shared humanity. Less- than-wholesome characters are manipulating our information channels, preying on our ignorance, our fears, and our base survival instincts. I say this, aware that I am being tracked by an algorithm on my social media that continues to feed me more of what it thinks will keep me on the platform, creating an echo chamber, which of course is also unhealthy in itself.
I continue to be troubled, however, in feeling complicit and guilty through my own limited action, or indeed inaction, as I try and focus on my own family, business and community as a priority. I wonder how history will judge us in Ireland, and the world powers, as we walk a tightrope of minding our own corner so as not to upset economic arrangements and international relations on one hand, and expressing our outright disdain for the behaviour of some world leaders, and the Israelis’ treatment of the Palestinian people in their own homeland.
Apparently we, as humans, tend to overestimate what we can achieve or change (good or bad I would
think) in a year or two, and tend to underestimate this over a 10-year time horizon. Where that will leave us in terms of our pharmacy businesses, or indeed the state of the world our children will be growing up into, remains to be seen.
I continue to assure myself that things are never as good or as bad as they seem, and try to refocus myself on getting back to our privileged day-to-day, and trying to find joy in that, which doesn’t always come easy. Not to me anyway, and to many of our patients for that matter. I’d like to be more optimistic about what the future holds. It’s not happening this morning, however.
Ultan Molloy is a business and professional performance coach, pharmacist, facilitator, and development specialist. He works with other pharmacists, business owners, and third parties to develop business strategies. Ultan can be contacted on 086 169 3343.
