Irish pharmacy and drug shortages, the gift that keeps on giving. A place where medicines exist in some sort of Schrodinger state, both there and not there at the same time. Sometimes the supply chain acts like it’s auditioning for a dystopian drama. It now feels as if we are the best part of a decade into an ever worsening farce. Drug shortages have even been making Prime Time, stressing out patients, carers, prescribers, and that one pharmacist, somewhere, who just wants to survive the day without being yelled at. In a fit of New Year positivity, I thought that if we can’t laugh about shortages, we might cry — and good luck finding tissues; since the storm in Holyhead, they’re probably in short supply too. Then I realised that my sense of humour was running thin.

I arrived back to the pharmacy after a two-week sojourn in the wonderful subcontinent of India. If you’ve ever wondered why critical medication is suddenly as elusive as a unicorn, it’s not because they are all being sold in the pharmacies of India. They seem to have just as many stock shortages as we have, albeit a less constrained distribution system. They also have a total ban on TikTok, thus avoiding the worst of urban marketing of lifestyle drugs. Regardless, back in the real world, the first shortage to grab my attention was methotrexate 2.5mg tablets. This is a staple of rheumatology. There are three licensed brands sold in Ireland, none of which are available. Now, I don’t want to sound like a broken record, but I am irritated to the core by this shortage. It wasn’t too long ago that they were previously in short supply. It is, to my mind, not good enough that we are replicating the same shortages over and over again. You look at the HPRA drug shortages site and see, “Appropriate alternative medicine authorised”. Within these four words, a whole encyclopaedia of derivatives flow. Once upon a time, I got really annoyed with that sentence, which, to my uninformed mind, signified bureaucracy at its worst. It took a few emails to explain, in simple language, that the form of words was factually correct. The missing part of this particular jigsaw is the circularity of the statement, as there is no link to the alternative, which is typically also unavailable. To add insult to injury, only two of the three authorised brands are officially listed as short on the HPRA shortages list. Drug shortages have been at the top of many agendas for quite a while. Yet we seem to be no further towards practical steps to help pharmacies cope. At this stage you would think we would have clear guidelines. For instance, Estradot 37.5 reappeared a few weeks ago, but it’s older sibling, the 75mcg patch, still hasn’t returned. Can a pharmacist dispense a double quantity of the lower strength in lieu of the higher strength. Is it legal? Will we be reimbursed on the State schemes? These are simple everyday questions for which there is zero official guidance. Indeed, calls to the PCRS may elicit directly opposing answers. Yet, the State was well able to spin in relation to their inability to deliver a HRT solution, regardless of the fact that the most common HRT formulations are unavailable. It is hard not to get frustrated.

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It is with profound sadness that I heard of the sudden passing of Padraic Staunton, an exceptional pharmacist and a true colossus of the profession. Padraic’s unexpected departure has left a void in the hearts of his family, friends, colleagues, and the countless patients whose lives he touched.

Padraic’s career was marked by his unwavering dedication to the profession of pharmacy, both locally and nationally. He was not only a skilled pharmacist but also a visionary leader and an amazing negotiator. He was Chairman on Contractors during a most successful part of the IPU’s history, the delivery of the new pharmacy contract.

Of his many great assets, his smile, a great sense of humour and an ability to gut to the core of an issue quickly stood out. Having seen him in action, he was steely across the table. Willing and able to fight his corner, he was one of the rare breed that could bring everyone along with him.

I last met Padraic on the streets of Westport. We headed for coffee and a catch up. He had recently retired from pharmacy, but not work. That was the kind of person he was, always delivering.

While anyone that knew him will feel sadness, it is little compared to the crushing loss that Brenda and his family are feeling. If it is of comfort, they should know that we all mourn the colossus of the profession that was Padraic Staunton, RIP.