IPU President attacks disproportionate FEMPI cuts on community pharmacists

• Criticises failure of Government to honour commitment to ease burden

5 May 2017: The failure of the Government to honour a clear commitment to begin unwinding the disproportionate burden of payment cuts on pharmacists under the FEMPI[1] legislation was strongly criticised by the President of the Irish Pharmacy Union, Mr Daragh Connolly, in his opening address to the Irish Pharmacy Union’s National Pharmacy Conference in Croke Park today (Friday).

He said that “no other healthcare profession has had to endure cuts in the region of €2.6 billion in the last eight years, through a combination of reduced reimbursement prices for medicines, repeated cuts to pharmacy margins and significant cuts to pharmacists’ direct remuneration – fee reductions and elimination of mark-ups on State-funded schemes.”

At the same time, Mr Connolly – a community pharmacist in Dungarvan – said pharmacists were being buried under an ever-increasing burden of regulatory and administrative demands, while having to pay among the highest pharmacy registration fees in the world.

In comparison to other professionals providing services on behalf of the HSE, and other similar groups in receipt of State payments, pharmacists had been hugely and disproportionately impacted by the FEMPI legislation from the outset. “We welcomed the clear commitment of the previous Minister to commence the unwinding of the savage reductions in payments to community pharmacy contractors, which were introduced under the FEMPI Act. However, to date, we have failed to see one cent returned. This is completely intolerable and unacceptable to our members. Pharmacists expect equitable treatment and that Government will keep its word; nothing more, nothing less. “Acknowledging receipt of a letter from the Department of Health the previous evening on this issue he hoped that this was an indication of the Minister’s intention to make genuine progress on this matter”.

The IPU President said his organisation strongly supported the Department of Health’s policy statement promising “a decisive shift towards primary care in the delivery of health services in Ireland, which may be seen as a core component in the development of a more integrated health service”, and added that the network of community pharmacies, employing over 20,000 staff nationwide, could play a vital role in delivering this model of healthcare.

“The pharmacist is often the only healthcare professional immediately accessible to people in their own communities. At a time when many villages and small towns around the country no longer have a bank, a Garda station, a post office or, in some cases, a GP service, local pharmacies remain a vital cornerstone of that community”.

He referenced the recommendations of the Joint Oireachtas Committee on Health and Children in 2015 to expand the role of the pharmacist, and the Pharmaceutical Society of Ireland’s report, ‘Future of Pharmacy Healthcare – Meeting Patients’ Needs’, published recently, which concluded that the only affordable solution to meeting increased patient demands was through a multi-disciplinary approach to healthcare, where the highest quality of care was delivered as close to the patient’s home as possible.

“A critical part of the delivery of this care is through the utilisation of the skills and accessibility of community pharmacists,” the IPU President said.

Citing data from the research company Behaviour & Attitudes, which found that more than 9 in 10 pharmacy users believed that the pharmacy was a good place to make more healthcare services available, and wanted to see the range of services provided by community pharmacists expanded, he said that there was a clear public demand “for better availability of primary healthcare services in the community, and the solution to filling that gap can come from community pharmacy”.

And there was compelling international evidence and experience to show that providing community pharmacists with a greater role benefits people’s health outcomes and the healthcare systems themselves. “Community pharmacists are enthusiastic to do more, to manage patients as well as dispense prescriptions, and we should help them to do more – to manage minor ailments, administer more vaccines, and do more medicine management and monitoring.”

Mr Connolly said that pharmacists did not want to replace GPs or other healthcare professionals. “We simply want to complement their services and use our expertise for the benefit of our communities. We want to allow under-pressure GPs to concentrate on diagnosis and on treating patients with more serious conditions. The evidence confirms that providing these additional pharmacy services has resulted in better health outcomes for patients, with fewer unscheduled GP visits, fewer hospital admissions and a reduction in mortality.”

In pursuit of a broader self-care agenda, the IPU has long advocated that a wider range of safe and effective treatments be made available without prescription. “We would like to see the list extended to include, for example, sumatriptan for migraine, newer anti-allergy medicines like fexofenadine and a wider range of analgesics, which are already available without prescription in the UK and elsewhere. Why are Irish patients and consumers forced to get prescriptions for medicines which should not require a prescription?

“We are delighted that, thanks to this Minister’s action, women who hold medical cards will soon have appropriate access to emergency contraception in pharmacies, as private patients already can, without having to make an unnecessary trip to the GP.

“We want to see the Minor Ailment Scheme – which was successfully piloted last year by the IPU and the HSE – rolled out nationally, so that medical card holders can get treatment for specified minor conditions directly from their pharmacist,” he said, adding that these were examples of the real public benefit that results from modernising how healthcare is delivered and promoted through pharmacies.