23 January was a milestone day that saw the formal appointment of the 35th Government of Ireland. The coalition of Fianna Fáil, Fine Gael and a collection of Independent TDs took power after agreeing a Programme for Government that includes a series of commitments in relation to health and pharmacy policy.
Chief among these is an intention to review the pharmacy fee structure. In addition, the new Government has signalled an intention to appoint a Chief Pharmacist in the Department of Health, expand pharmacy services through a Common Conditions Service, streamline reimbursement procedures and be more proactive in the management of medicine shortages.
Against this backdrop, the Dáil resumed along with familiar questions such as those relating to the proposed HRT Scheme, the appointment of a Chief Pharmacist in the Department of Health and the national vaccination programme.
In one of the first interactions on pharmacy services within the new Dáil, Deputy Pádraig O’Sullivan (Cork North-Central, Fianna Fáil) asked the newly appointed Minister for Health Jennifer Carroll MacNeill (Fine Gael, Dún Laoghaire) about plans to expand pharmacy services.
Deputy O’Sullivan asked about plans “to appoint a new Chief Pharmacist to the Department and when she hopes to be in a position to make such an appointment”. He also asked about plans for “a review on the pharmacy fee structure”.
The Minister for Health began her response highlighting that, “pharmacists play a crucial role, delivering many important services to support the health of our communities, offering expert advice on illness, ensuring the safe supply of medicines, and delivering vaccines to the public”.
The Minister told the Deputy that she believes pharmacists can do more for the health service stating that she is a “huge advocate for the reform and expansion of pharmacy services.” The Minister spoke about the Expert Taskforce to Support the Expansion of the Role of Pharmacy and noted progress in this regard in relation to the scope of practice for a pharmacist.
The Minister stated that her Department is, “prioritising delivery of all the regulatory services that will enable community pharmacies to establish Common Conditions Services”.
Concluding her response, the Minister noted that her officials will, “progress a focused examination and scoping work on the remaining recommendations of the Taskforce, including the role of a Chief Pharmaceutical Officer, with a view to establishing an approach to further expand the role of pharmacists”.
The proposal, announced in the last Budget, to introduce a scheme to fund the costs of HRT medications has been a keen focus in the early days of the new Dáil. A commitment had been made during the Budget for this scheme to be in operation from January.
Among the many parliamentary questions raised on the topic was that of Deputy Joe Neville (Kildare North, Fine Gael) who asked the Minister for Health “when the free HRT scheme, which was announced in Budget 2025 will become available and if there is a timeframe for the rollout of the scheme”.
Minister for Health, Jennifer Carroll MacNeill answered Deputy Neville by outlining that, “Budget 2025 announced the intention to fund the medicine cost of HRT products prescribed to a woman to help manage the symptoms associated with all stages of the menopause” and that “the Health Insurance (Amendment) and Health (Provision of Menopause Products) Bill 2024 passed all stages in the Oireachtas and was signed into law”.
The Minister summarised that the legislation meant that, “where a woman has been prescribed a HRT product by her healthcare provider to alleviate the symptoms associated with all stages of menopause, the cost of HRT medications or products will be met by the State.”
Additionally, informing the Deputy, the Minister said that “the cost of GP consultation fees and dispensing fees are not including in the measure” and “the Department of Health engaged both the HSE and the IPU in relation to the practical rollout of this measure” with the Department of Health looking to introduce this measure as soon as possible.
Elaborating the Minister addressed the ongoing challenges created by shortages of certain HRT medicines. She said she was aware of the “stress that shortages can cause for patients and healthcare professionals”.
Several other TDs also asked questions about HRT including Catherine Connolly (Galway West, Independent), James O’Connor (Cork East, Fianna Fáil) and Sinéad Gibney (Dublin Rathdown, Social Democrats).
Minister Carroll MacNeil acknowledged that “menopause is such an important health and wellbeing issue” and that “much important work has been done in this area, driven by the Women’s Health Taskforce and the Women’s Health Action Plans”.
Deputy Ryan O’Meara (Tipperary North, Fianna Fáil) asked the Minister for Health if she “plans to expand the age cohorts included under the free contraception scheme”.
Minister Carroll MacNeill began by summarising the free contraception scheme, noting that the scheme now included women aged 17-35 from 1 July and that the “scheme covers the cost of consultations with GPs, primary care, student health and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Reimbursement List”.
The Minister also outlined that the Programme for Government 2025, “commits to continuing to extend access to free contraception” and that the “Department is working on the development of the necessary implementation enablers for contraceptive prescribing by pharmacists to extend or continue a prescription for contraception as part of the work of the Community Pharmacy Expansion Implementation Oversight Group”.
Deputy Emer Currie (Dublin West, Fine Gael) asked the Minister for Health about the shingles vaccine and if “she intends to set a deadline” for including the vaccine in the national immunisation programme.
The Minister for Health told the Deputy that the shingles vaccine was not currently part of the immunisation programme but that “it is open to any individual who is aged 50 years and older and anyone who wishes to receive the vaccine to consult with their GP or pharmacist.”
The Minister stated that the Health Information and Quality Authority (HIQA) found that “adding the Shingles vaccines to the programme is not cost effective and is associated with a substantial budget impact”.
Deputy Michael Murphy (Tipperary South, Fine Gael) asked the Minister for Health, “if she would consider making the medication Linaclotide available via the Drugs Payment Scheme as this medication is very expensive”.
The Minister provided a summary of the pricing and reimbursement of medicines under the Community Drugs Scheme, in accordance with the Health Act 2013. Highlighting Linaclotide, the Minister informed the Deputy that “I have asked the HSE to provide an update” and that the “Corporate Pharmaceutical Unit (CPU) is the unit within the HSE that is responsible for accepting and considering price and reimbursement applications from the pharmaceutical industry”.
Finishing her remarks, the Minister told the Deputy that the CPU had received a pricing and reimbursement application for Linaclotide under the Community Drugs Scheme in May 2013, but following the disengagement of the applicant from the pricing and reimbursement process “the reimbursement of Linaclotide has not been pursued to date” and the “CPU have not received any communication from a pharmaceutical company indicating an imminent price and reimbursement application for the medication”.
Brian Harrison
Director, MKC Communications
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