The year started with the publication of the potentially landmark Health (Miscellaneous Provisions) Bill 2024. The Bill aims to lay the ground for an enhanced role for pharmacists in Ireland.
Included in the provisions of the legislation are changes to the 1995 Irish Medicines Board Act to enable pharmacists to sell and supply certain medicines without the need for a prescription. Amongst the planned medications would be the oral contraceptive pill as part of the Free Contraception Scheme.
The Bill will also give the Health Minister power to make regulations to deal with medicine shortages. These would enable pharmacists to make therapeutic substitutions, in line with an approved clinical protocol.
Speaking when the legislation was published, Minister for Health Stephen Donnelly TD (Fianna Fáil, Wicklow) said; “We know that pharmacists can do more for patients and I have been clear that I want to further enhance the contribution that pharmacists make to our health services, and this will be an important step forward.”
Separately, Minister Donnelly was asked by Deputy Richard Bruton (Dublin Bay North, Fine Gael) for updates on the Expert Taskforce examining the role of pharmacies. The Minister explained that there was no update as of January 2024 and that he was “awaiting a reply from his Department”.
Medical cards and eligibility for the Long-Term Illness Scheme (LTI) were raised multiple times in recent weeks including from Deputies Brendan Griffin (Kerry, Fine Gael) and Paul Murphy (Dublin South West, RISE) who asked about which illnesses qualify for the medical card.
In response to both, Minister for Health Stephen Donelly said that there were “currently no plans in place to extend the list of conditions covered under the LTI scheme, but that the scheme itself exists within a wider eligibility framework”.
Deputy Colm Burke (Cork North Central, Fine Gael) also asked Minister Donnelly, if he would “take steps to ensure that all heart failure patients are eligible for a medical card and to remove prescription charges”. The Deputy also acknowledged the significant financial pressures that many are facing.
The ongoing rollout and expansion of the free contraception scheme received further scrutiny. Deputy Gino Kenny (Dublin Mid West, People Before Profit) asked the Minister of State, Hildegarde Naughton (Galway West, Fine Gael) why the free contraception scheme is only available for 17 to 31-year-olds and the rationale behind “limiting this scheme to this age bracket only”.
The Minister responded by summarising the free contraception scheme and how the age bracket in 2022 was only up to 25 years old.
The Minister further agreed that “there is no public health related reason to limit the scheme by age”, adding that there were recommendations put in place for the phased introduction of the scheme, by the Report of the Working Group on Access to Contraception. The Minister added that any future decision relating to the “further expansion of the scheme will be a matter for the estimates process in advance of Budget 2025”.
Deputy Duncan Smith (Dublin Fingal, Labour) also asked the Minister for State, Hildegarde Naughton on the number of people who have “availed of emergency contraception under the free contraception scheme”, with the Minister deferring to the HSE for a response.
The administration of various vaccines and the role of pharmacies within this has been topical. The shingles vaccine was raised by Deputy Fergus O’Dowd (Louth, Fine Gael) and Deputy Mark Ward (Dublin Mid West, Sinn Fein), who both asked the Minister for Health about the cost of the vaccine, with Deputy O’Dowd asking if he had plans to “introduce a free shingles vaccination scheme for older adults”. The Minister advised the Deputy that the immunisation programme in Ireland is based on the advice from the National Immunisation Advisory Committee (NIAC).
Deputy Duncan Smith (Dublin Fingal, Labour) queried the Minister for Health about the RSV vaccine and asked if “he will expand the regulation to permit pharmacists to administer the vaccine”. The Minister highlighted in his response that ‘Medicinal Products Regulations 2003’, outlines what can be administered by a pharmacist, and stated that there are “currently no plans in place to amend the legislation to permit pharmacists to administer the RSV vaccine”.
The Oireachtas Petition Committee discussed a request to cut and cap the price of generic over-the-counter pain relief medications, such as paracetamol, ibuprofen and aspirin. Deputy Martin Browne (Tipperary, Sinn Féin) outlined costs, citing “a local pharmacy in Wexford town, (where) a 24-pack of 400 mg ibuprofen, unbranded, costs €9.75. Per 400 mg dose, that is a cost of 41 cent. Over the Border, in the UK, non-brand ibuprofen from the supermarket costs 6 cent.”
The Committee liaised with the Competition and Consumer Protection Commission who advised the Committee that, “the CCPC will continue to engage as appropriate with the HPRA and other relevant authorities to remove unnecessary barriers to competition, potentially leading to more competitive prices for consumers.”
Ultimately the Committee agreed to write to the HPRA to inquire about licensing costs on the various medications.
The topic of electronic prescriptions arose in the Oireachtas Health Committee during a hearing with officials from the Department of Health. Deputy Colm Burke (Cork North Central, Fine Gael) described how “a whole lot of people have to attend GPs because you cannot open up the whole distribution of medication”.
Deputy Burke suggested, “If it is a non-prescriptive drug, you could go into ten different pharmacies and get the same drug on the one day whereas if all of that is computerised you could give a lot more work out to pharmacies and people would not have to go to GPs for prescriptions.”
Derek Tierney from the Department of Health said, “Our local pharmacies are equipped with IT infrastructure and they are now connected through Healthlink. One of the greatest innovations during COVID was GPs being able to send electronic prescriptions directly to the pharmacy so there was no paper travelling . . . We will build on that by rolling out an e-prescription solution.”
Deputy Emer Higgins (Dublin Mid-West, Fine Gael) asked the Minister for Health about the actions that are being taken to ensure public awareness and accessibility of vitamin D supplements.
In response, Minister of State Hildegarde Naughton said, “Resources have been produced by the Department of Health to indicate the recommended amount of Vitamin D based on your age and situation and they are available on HSE and gov.ie websites. The resources are being distributed to health centres and pharmacies around the country, so healthcare professionals can advise the public on appropriate supplement intakes.”
Brian Harrison
MKC Communications
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